Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2021, 165(2):224-228 | DOI: 10.5507/bp.2020.026

The use of a battery of examination methods for detection of cervical metastases in squamous cell carcinoma of the oral cavity

Jan Stembireka, b, Zuzana Cermakovac, e, Michal Kulnigc, Pavel Hurnikd, Jakub Cveke, Kamila Resovae, Tomas Jonsztaf, Martina Litschmanovag, Jiri Stranskya
a Department of Oral and Maxillofacial Surgery, University Hospital Ostrava, Czech Republic
b Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Czech Republic
c Faculty of Medicine, University of Ostrava, Czech Republic
d Department of Pathology, University Hospital Ostrava, Czech Republic
e Department of Oncology, University Hospital Ostrava, Czech Republic
f Department of Radiology, University Hospital Ostrava, Czech Republic
g Department of Applied Mathematics, Faculty of Electrical Engineering and Computer Science, SB-Technical University Ostrava, Czech Republic

Introduction: In patients with squamous cell carcinoma of the orofacial area, the presence of cervical metastases represents a single most significant prognostic factor. This fact underlines the importance of thorough examination of the cervical lymph nodes for potential tumor involvement. To verify this, the most common investigative methods are physical examination (PE), sonography (US) and computed tomography (CT), which have also been used to assess the stage of the disease in the patients in our research.

Objective: To evaluate the performance of individual methods (physical examination, sonography, computed tomography) and combinations.

Method: Patients with squamous cell carcinoma of the oral cavity, who had undergone physical, US and CT examinations at our department followed by radical neck dissection were included in this retrospective study. A total of 57 patients were included.

Results: The sensitivity of PE, US and CT were 38%, 69% and 61%, respectively, however CT+US combination yielded 83% sensitivity and combination of all these methods 86% sensitivity. The number of false positives was however relatively high with specificity of the 3-way combination at 65%.

Conclusion: A combination of our three widely available inexpensive methods detected 86% of metastases in cervical nodes. The large number of false positives however indicates that the method should rather be used for screening in selecting patients who need additional and more expensive imaging than for diagnosing cervical metastases. Also, as 14% of cervical metastases pass undetected using our method, we would recommend an additional examination at least by US+PE several weeks to a few months after the initial examination.

Keywords: squamous cell carcinoma, oral cavity, cervical metastasis, radical neck dissection, sonography, computed tomography

Received: December 16, 2019; Revised: May 28, 2020; Accepted: June 11, 2020; Prepublished online: June 26, 2020; Published: June 10, 2021  Show citation

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Stembirek, J., Cermakova, Z., Kulnig, M., Hurnik, P., Cvek, J., Resova, K., ... Stransky, J. (2021). The use of a battery of examination methods for detection of cervical metastases in squamous cell carcinoma of the oral cavity. Biomedical papers, 165(2), 224-228. doi: 10.5507/bp.2020.026
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