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Ultrasound, ultrasound guided FNAC and CT for the detection of neck node metastases in clinically N0 patients with carcinoma of upper aero-digestive tract (348P)

Date

18 Nov 2017

Session

Poster lunch

Presenters

Abhishek Bajracharya

Citation

Annals of Oncology (2017) 28 (suppl_10): x100-x110. 10.1093/annonc/mdx665

Authors

A.M. Bajracharya

Author affiliations

  • Radiodiagnosis, Lumbini Medical College and Teaching Hospital, 000 - Tansen/NP
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Resources

Background

Presence of clinically occult cervical lymph metastases in patients with squamous cell carcinoma (SCCA) of upper aero-digestive tract and clinically negative (cN0) necks alters the management and prognosis. Ultrasound of the neck is a useful but not standard part of pre-treatment work up in these patients.

Methods

One hundred eighty newly diagnosed patients with SCCA of upper aero-digestive tract and cN0 necks were evaluated with pre-treatment ultrasound with power Doppler and CT of the neck. In patients who underwent neck dissection, the imaging findings were correlated with histopathology of lymph nodes. Abnormal lymph nodes detected on imaging were subjected to ultrasound guided FNAC, if neck dissection was not planned. Ultrasound and CT findings were compared with each other and also correlated with pathological lymph node status.

Results

Abnormal lymph nodes suspicious for metastases were detected in 64 (35.6%) patients on ultrasound and 44 (24.4%) patients on CT. Sixteen ultrasound positive patients had non enlarged lymph nodes. All CT positives lymph nodes were detected on ultrasound. Pathological lymph node status was available in 84 patients and 48 of them had nodal metastases. Ultrasound was positive in all 48 patients and CT was positive in 36 of them. Sensitivity, specificity and negative predictive values were 100%, 88.9% and 100% for ultrasound and 75%, 88.9% and 72.7% for CT respectively.

Conclusions

Ultrasound compliments the CT to improve the detection of lymph node metastases in cN0 patients. It may be useful in indentifying patients suitable for conservative neck management.

Clinical trial identification

Legal entity responsible for the study

Abhishek Man Bajracharya

Funding

None

Disclosure

All authors have declared no conflicts of interest.

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