J Korean Assoc Oral Maxillofac Surg.  2006 Apr;32(2):151-156.

Accuracy of preoperative assessments for cervical lymph node metastasis in oral cancer

• Lee JJ
• Nam W
• Cha IH

Abstract

PURPOSE
The aim of this study was to determine the accuracy of clinical and radiologic assessments in detecting positive cervical lymph nodes in oral cancer.
MATERIALS AND METHODS
We had reviewed the preoperative clinical, radiologic and postoperative histopathologic reports of 46 patients who had been diagnosed as oral cancer and underwent surgical excision combined with neck dissection (52 sides of neck) in the Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University from the July 1, 1992 to the April 30, 1999.
RESULTS
The results were as follows 1. The male to female ratio was 4.38 : 1 and the mean age was 57. 2. Sensitivity values for the preoperative assessment of cervical lymph node metastasis in oral cancer were 62.5 % in clinical examination and 50.0 % in radiologic assessments. Specificity values were 77.8 % in clinical examination and 94.4 % in radiologic assessments. 3. False positive values were 44.4 % in clinical examination and 20.0 % in radiologic assessments. False negative values were 17.6 % in clinical and 19.0% in radiologic assessments. 4. Overall efficiency values were 73.1 % in clinical examination and 80.8 % in radiologic assessments. SUMMARY: There were some limits on the accuracy of clinical and radiologic assessments in the preoperative detection of the cervical lymph nodes in oral cancer. To improve the accuracy, it is important to communicate between clinician and radiologist, and adjunctive diagnostic measures, ultrasound and fine needle aspiration cytology, were helpful increasing the overall efficiency. In the high risk sites (oral tongue and floor of the mouth) the false negative value is higher and the overall efficiency in radiologic evaluation is lower than those of the low risk sites (gingiva and alveolar ridge, retromolar trigone and buccal mucosa). The elective neck dissection should be considered in the high risk sites.

Keyword

Oral cancer; Cervical lymph node metastasis; Overall efficiency

MeSH Terms

Alveolar Process
Biopsy, Fine-Needle
Dentistry
Female
Humans
Lymph Nodes*
Male
Mouth Neoplasms*
Neck Dissection
Neoplasm Metastasis*
Sensitivity and Specificity
Surgery, Oral
Tongue
Ultrasonography