Original Article

Diagnostic utility of central node necrosis in predicting extracapsular spread among oral cavity squamous cell carcinoma

Derrick R. Randall MD, MSc

Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

John T. Lysack MD, MSc,

John T. Lysack MD, MSc

Division of Neuroradiology, Department of Radiology, University of Calgary, Calgary, Alberta, Canada

Ohlson Research Initiative, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

Marc E. Hudon MD,

Marc E. Hudon MD

Division of Neuroradiology, Department of Radiology, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

Kelly Guggisberg MD,

Kelly Guggisberg MD

Department of Pathology, Calgary Laboratory Services and University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

Steven C. Nakoneshny BSc,

Steven C. Nakoneshny BSc

Ohlson Research Initiative, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

T. Wayne Matthews MD,

T. Wayne Matthews MD

Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada

Ohlson Research Initiative, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

Joseph C. Dort MD, MSc,

Joseph C. Dort MD, MSc

Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada

Ohlson Research Initiative, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

Shamir P. Chandarana MD, MSc,

Corresponding Author

Shamir P. Chandarana MD, MSc

Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada

Ohlson Research Initiative, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada

Corresponding author: S. Chandarana, Foothills Medical Centre, South Tower, Room 602, 1403 29 Street, NW, Calgary, Alberta T2N 2T9, Canada. E-mail: [email protected]Search for more papers by this author

Derrick R. Randall MD, MSc,

Derrick R. Randall MD, MSc

Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

John T. Lysack MD, MSc,

John T. Lysack MD, MSc

Division of Neuroradiology, Department of Radiology, University of Calgary, Calgary, Alberta, Canada

Ohlson Research Initiative, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

Marc E. Hudon MD,

Marc E. Hudon MD

Division of Neuroradiology, Department of Radiology, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

Kelly Guggisberg MD,

Kelly Guggisberg MD

Department of Pathology, Calgary Laboratory Services and University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

Steven C. Nakoneshny BSc,

Steven C. Nakoneshny BSc

Ohlson Research Initiative, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

T. Wayne Matthews MD,

T. Wayne Matthews MD

Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada

Ohlson Research Initiative, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

Joseph C. Dort MD, MSc,

Joseph C. Dort MD, MSc

Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada

Ohlson Research Initiative, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada

Search for more papers by this author

Shamir P. Chandarana MD, MSc,

Corresponding Author

Shamir P. Chandarana MD, MSc

Division of Otolaryngology – Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada

Ohlson Research Initiative, Southern Alberta Cancer Research Institute, University of Calgary, Calgary, Alberta, Canada

First published: 11 December 2013

https://doi.org/10.1002/hed.23562

Citations: 26

This work was presented at the American Head and Neck Society's 8th International Conference on Head and Neck Cancer, Toronto, Ontario, Canada, July 21–25, 2012.

Share a link

Email
Wechat
Bluesky

ABSTRACT

Background

Oral cavity squamous cell carcinoma (SCC) represents the most common SCC affecting the head and neck region. Long-term survival of patients with oral cavity SCC is adversely affected by lymph node metastasis and further decreased by the presence of lymph node extracapsular spread (ECS).

Methods

Using a case-control design, preoperative CT scans from patients with oral cavity SCC and metastatic lymphadenopathy were evaluated by 2 independent neuroradiologists, blinded to the study, for a number of radiologic parameters, including central node necrosis. Multivariate logistic regression was used to identify parameters independently predicting pathologic ECS.

Results

For both neuroradiologists, central node necrosis was a significant predictor of ECS, with high interrater agreement (kappa = 0.71). On multivariate analysis, only central node necrosis independently predicted ECS (odds ratio [OR] = 12.1; 95% confidence interval [CI] = 1.24–119). Central node necrosis predicted ECS with 91% sensitivity and 88% negative predictive values.

Conclusion

REFERENCES

1Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin 2010; 60: 277–300.
10.3322/caac.20073
CAS PubMed Web of Science® Google Scholar
2 Canadian Cancer Society. Incidence and mortality by cancer type. In: Canadian Cancer Society's Steering Committee on Cancer Statistics. Canadian Cancer Statistics 2012. Toronto, Ontario, Canada: Canadian Cancer Society; 2012. p. 8.
Google Scholar
3Huang DT, Johnson CR, Schmidt–Ullrich R, Grimes M. Postoperative radiotherapy in head and neck carcinoma with extracapsular lymph node extension and/or positive resection margins: a comparative study. Int J Radiat Oncol Biol Phys 1992; 23: 737–742.
10.1016/0360-3016(92)90646-Y
CAS PubMed Web of Science® Google Scholar
4Suoglu Y, Erdamar B, Katircioglu OS, Karatay MC, Sunay T. Extracapsular spread in ipsilateral neck and contralateral neck metastases in laryngeal cancer. Ann Otol Rhinol Laryngol 2002; 111(5 Pt 1): 447–454.
10.1177/000348940211100510
Web of Science® Google Scholar
5Clark J, Li W, Smith G, et al. Outcome of treatment for advanced cervical metastatic squamous cell carcinoma. Head Neck 2005; 27: 87–94.
10.1002/hed.20129
CAS PubMed Web of Science® Google Scholar
6Shaw RJ, Lowe D, Woolgar JA, et al. Extracapsular spread in oral squamous cell carcinoma. Head Neck 2010; 32: 714–722.
10.1002/hed.21244
PubMed Web of Science® Google Scholar
7Larsen SR, Johansen J, Sørensen JA, Krogdahl A. The prognostic significance of histological features in oral squamous cell carcinoma. J Oral Pathol Med 2009; 38: 657–662.
10.1111/j.1600-0714.2009.00797.x
CAS PubMed Web of Science® Google Scholar
8Liao CT, Huang SF, Chen IH, et al. Risk stratification of patients with oral cavity squamous cell carcinoma and contralateral neck recurrence following radical surgery. Ann Surg Oncol 2009; 16: 159–170.
10.1245/s10434-008-0196-4
PubMed Web of Science® Google Scholar
9Liao CT, Lin CY, Fan KH, et al. Outcome analyses of unusual site neck recurrence in oral cavity cancer. Ann Surg Oncol 2013; 20: 257–266.
10.1245/s10434-012-2580-3
PubMed Web of Science® Google Scholar
10Liao CT, Chang JT, Wang HM, et al. Preoperative [18F]fluorodeoxyglucose positron emission tomography standardized uptake value of neck lymph nodes predicts neck cancer control and survival rates in patients with oral cavity squamous cell carcinoma and pathologically positive lymph nodes. Int J Radiat Oncol Biol Phys 2009; 74: 1054–1061.
10.1016/j.ijrobp.2008.09.045
PubMed Web of Science® Google Scholar
11Kuhnt T, Klockenbrink U, Knipping S, et al. Adjuvant low single dose cisplatin-based concurrent radiochemotherapy of oral cavity and oropharynx carcinoma: impact of extracapsular nodal spread on distant metastases. Strahlenther Onkol 2011; 187: 292–299.
10.1007/s00066-011-2186-x
PubMed Web of Science® Google Scholar
12Bernier J, Cooper JS, Pajak TF, et al. Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (#9501). Head Neck 2005; 27: 843–850.
10.1002/hed.20279
CAS PubMed Web of Science® Google Scholar
13Carvalho P, Baldwin D, Carter R, Parsons C. Accuracy of CT in detecting squamous carcinoma metastases in cervical lymph nodes. Clin Radiol 1991; 44: 79–81.
10.1016/S0009-9260(05)80500-8
CAS PubMed Web of Science® Google Scholar
14Yousem DM, Som PM, Hackney DB, Schwaibold F, Hendrix RA. Central nodal necrosis and extracapsular neoplastic spread in cervical lymph nodes: MR imaging versus CT. Radiology 1992; 182: 753–759.
10.1148/radiology.182.3.1535890
CAS PubMed Web of Science® Google Scholar
15Woolgar JA, Beirne JC, Vaughan ED, Lewis–Jones HG, Scott J, Brown JS. Correlation of histopathologic findings with clinical and radiologic assessments of cervical lymph-node metastases in oral cancer. Int J Oral Maxillofac Surg 1995; 24(1 Pt 1): 30–37.
10.1016/S0901-5027(05)80853-7
PubMed Web of Science® Google Scholar
16Zoumalan RA, Kleinberger AJ, Morris LG, et al. Lymph node central necrosis on computed tomography as predictor of extracapsular spread in metastatic head and neck squamous cell carcinoma: pilot study. J Laryngol Otol 2010; 124: 1284–1288.
10.1017/S0022215110001453
CAS PubMed Web of Science® Google Scholar
17van den Brekel MW, Stel HV, Castelijns JA, et al. Cervical lymph node metastasis: assessment of radiologic criteria. Radiology 1990; 177: 379–384.
10.1148/radiology.177.2.2217772
PubMed Web of Science® Google Scholar
18Ang KK, Harris J, Wheeler R, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 2010; 363: 24–35.
10.1056/NEJMoa0912217
CAS PubMed Web of Science® Google Scholar
19van den Brekel MW, Lodder WL, Stel HV, Bloemena E, Leemans CR, van der Waal I. Observer variation in the histopathologic assessment of extranodal tumor spread in lymph node metastases in the neck. Head Neck 2012; 34: 840–845.
10.1002/hed.21823
PubMed Web of Science® Google Scholar
20Ferlito A, Rinaldo A, Devaney KO, et al. Prognostic significance of microscopic and macroscopic extracapsular spread from metastatic tumor in the cervical lymph nodes. Oral Oncol 2002; 38: 747–751.
10.1016/S1368-8375(02)00052-0
PubMed Web of Science® Google Scholar
21Greenberg JS, Fowler R, Gomez J, et al. Extent of extracapsular spread: a critical prognosticator in oral tongue cancer. Cancer 2003; 97: 1464–1470.
10.1002/cncr.11202
PubMed Web of Science® Google Scholar
22Dedivitis RA, Denardin OV, Castro MA, Pfuetzenreiter EG Jr. [Risk factors for distant metastasis in head and neck cancer]. Rev Col Bras Cir 2009; 36: 478–481. [Article in Portuguese].
10.1590/S0100-69912009000600003
PubMed Google Scholar

Citing Literature

Volume37, Issue1

January 2015

Pages 92-96

Diagnostic utility of central node necrosis in predicting extracapsular spread among oral cavity squamous cell carcinoma

ABSTRACT

Background

Methods

Results

Conclusion

REFERENCES

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Diagnostic utility of central node necrosis in predicting extracapsular spread among oral cavity squamous cell carcinoma

ABSTRACT

Background

Methods

Results

Conclusion

REFERENCES

Citing Literature

References

Related

Information