Radiology-Pathology Concordance and Prognostication of Nodal Features in pN+ Oral Cavity Cancer.

Autor:	Duguet-Armand M; Department of Neuroradiology, University of Toronto, Toronto, Ontario, Canada.; Department of Neuroradiology and Head and Neck Imaging, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Su J; Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., O'Sullivan B; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.; Department of Otolaryngology - Head & Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., de Almeida J; Department of Otolaryngology - Head & Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Hosni A; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Weinreb I; Department of Pathology, Princess Margaret Cancer Centre, University of Health Network, Toronto, Ontario, Canada., Perez-Ordonez B; Department of Pathology, Princess Margaret Cancer Centre, University of Health Network, Toronto, Ontario, Canada., Smith S; Department of Pathology, Princess Margaret Cancer Centre, University of Health Network, Toronto, Ontario, Canada., Witterick I; Department of Otolaryngology - Head & Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Yao C; Department of Otolaryngology - Head & Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Goldstein D; Department of Otolaryngology - Head & Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Hope A; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Hahn E; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Waldron J; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Ringash J; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.; Department of Otolaryngology - Head & Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Spreafico A; Division of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Yu E; Department of Neuroradiology, University of Toronto, Toronto, Ontario, Canada.; Department of Neuroradiology and Head and Neck Imaging, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada., Huang SH; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.; Department of Otolaryngology - Head & Neck Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	The Laryngoscope [Laryngoscope] 2024 Dec; Vol. 134 (12), pp. 4947-4955. Date of Electronic Publication: 2024 Jun 14.
DOI:	10.1002/lary.31578
Abstrakt:	Background and Purpose: The aims of our study are to evaluate the diagnostic performance and prognostic value of radiological lymph node (LN) characteristics in pN+ oral cavity squamous carcinoma (OSCC). Materials and Methods: pN+ OSCC treated between 2012 and 2020 were included. Preoperative imaging was reviewed by a single radiologist blinded to pathologic findings for the following nodal features: imaging-positive LN (iN+), laterality and total number, and image-identified extranodal extension (iENE). The sensitivity of iN+ for pN+ was calculated. The diagnostic performance of other nodal features was evaluated in the iN+ subgroup. The association of radiologic nodal features with overall survival (OS) was evaluated. Inter-rater kappa for radiologic nodal features was assessed in 100 randomly selected cases. Results: Of 406 pN+ OSCC, 288 were iN+. The sensitivity of iN+ for pN+ was 71% overall, and improved to 89% for pN+ LN >1.5 cm. Within iN+, sensitivity/specificity for LN size (>3 cm), total LN number (>4), and ENE were 0.44/0.95, 0.57/0.84, and 0.27/0.96, respectively. Sensitivity of iENE was higher in the subset, with major (>2 mm) versus minor (≤2 mm) pENE (43% vs. 13%, p = 0.001). Reduced OS was observed in iN+ versus iN- (p = 0.006), iENE+ versus iENE- (p = 0.004), LN size >3 versus ≤3 cm (p < 0.001), and higher LN number (p < 0.001). Inter-rater kappa for iN+, laterality, total LN number, and presence of iENE were 0.71, 0.57, 0.78, and 0.69, respectively. Conclusion: Our study shows that despite modest sensitivity of most radiological nodal features, the specificity of image-identified nodal features is high and their prognostic values are retained in pN+ OSCC. Level of Evidence: 3 (retrospective review comparing cases and controls) Laryngoscope, 134:4947-4955, 2024. (© 2024 The Author(s). The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze:	MEDLINE
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