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Introduction/Objectives: To assess the efficacy and correlation of MDCT scans in the clinical staging of patients with HNCs prior to therapeutic intervention. Methodology: Thirty-four HNCs were studied according to the 2005 WHO. Clinical AJCC 6th edition & radiological staging. Results: 14 Squamous Cell Carcinoma (SCC 41.2%) mean age 49.4 + 14.7 years, 13 Nasopharyngeal Carcinoma (NPC 38.2%) mean age 37.1 + 20.5 years, 3 Odontogenic Carcinoma (ODC 8.8% made up of 2 cases ameloblastic carcinoma 5.9% and 1 case of ameloblastic carcinosarcoma 2.9%). Others cases were 3 Adenocarcinoma (8.8%) and 1 Sinonasal Carcinoma NC (2.9%). Mean age insignificant according to gender (p = 0.342). Sensitivity, specificity, positive & negative predictive values and accuracy of clinical and radiological nodal involvements were: (47.4%; 80%; 61.8%; 75%; 54.5%) & (78.9%; 93.3%; 85.3%; 93.8%; 77.8%) respectively. Difference between clinical and radiological stages was statistically significant (X2= 260.8; p=0.01). There was a low but positive correlation between the clinical and radiologic stages (Pearson’s correlation r = 0.6). Conclusion: MDCT was significantly more accurate than clinical examination in the TNM of HNCs using AJCC/UICC TNM guidelines. Authors recommend MDCT as first line imaging technique in resource limited settings.References
Shishodia NP, Divakar DD, Al Kheraif AA, Ramakrishnaiah R, Pathan AA, Parine NR, et al. End stage palliative care of head and neck cancer: a case study. Asian Pac J Cancer Prev. 2015;16(3):1255-8.
Chin D, Boyle GM, Porceddu S, Theile DR, Parsons PG, Coman WB. Head and neck cancer: past, present and future. Expert Rev Anticancer Ther. 2006 Jul;6(7):1111-8.
Lam DK, Schmidt BL. Orofacial pain onset predicts transition to head and neck cancer. Pain. 2011 May;152(5):1206-9. doi: 10.1016/j. pain.2011.02.009.
Brockstein B, Haraf DJ, Rademaker AW, Kies MS, Stenson KM, Rosen F. et al. Patterns of failure, prognostic factors and survival in loco regionally advanced head and neck cancer treated with concomitant chemo radiotherapy: a 9-year, 337-patient, multi-institutional experience. Ann Oncol. 2004 Aug;15(8):1179-86.
Worsham MJ. Identifying the risk factors for late stage head and neck cancer. Expert Rev Anticancer Ther. 2011 Sep;11(9):1321-5. doi: 10.1586/era.11.135.
Lopez-jornet P, Camacho-Alomso F: New barriers in Oral Cancer. Patient accessibility to dental examination-A pilot Study. Oral Oncol. 2006 Nov;42(10):1022-5.
McCabe KJ, Rubinstein D: Advances in Head and Neck Imaging. Otolaryngol Clin North Am. 2005 Apr;38(2):307-19, vii.
Forghani R, Yu E, Levental M, Som PM, and Curtin HD: Imaging evaluation of lymphadenopathy and patterns of lymph node spread in head and neck cancer. Expert Rev Anticancer Ther. 2015 Feb;15(2):20724. doi: 10.1586/14737140.2015.978862.
Agarwal V, Branstetter IV BF, Johnson JT, Indications for PET/CT in the Head and Neck. Otolaryngol Clin North Am. 2008 Feb;41(1):23-49, v. doi: 10.1016/j.otc.2007.10.005.
Lell MM, Gmelin C, Panknin C, Eckel KT, Schmid M, Bautz WA, et al. Thin-Slice MDCT of the Neck: Impact on Cancer Staging. AJR Am J Roentgenol. 2008 Mar;190(3):785-9. doi: 10.2214/AJR.07.3081.
Hsu WC, Loevner LA, Karpati R, et al. Accuracy of magnetic resonance imaging in predicting absence of fixation of head and neck cancer to the prevertebral space. Head Neck. 2005 Feb;27(2):95-100.
Lell MM, Greess H, Hothorn T, Janka R, Bautz WA, Baum U. Multiplanar functional imaging of the larynx and hypopharynx with multi-slice spiral CT. Eur Radiol. 2004 Dec;14(12):2198-205.
Barnes L, Eveson J, Reichart P, Sidransky D, editors. World health organization classification of tumors. Pathology and genetics of head and neck tumors. Lyon: IARC Press; 2005.
Greene FL, Page DL, Fleming ID, Fritz AG, Balch C, Haller DG, et al., editors. The American Joint Committee on Cancer Staging Manual. 6th. New York: Springer; 2002.
Fleming ID, Cooper JS, Henson DE, Hutter RVP, Kennedy BJ, Murphy GP, et al., editors. AJCC cancer staging manual. 5th ed. Philadelphia: Lippincott-Raven; 1997. 294p.
Madison MT, MD, Remley KB, Richard MD. Radiologic diagnosis and staging of head and neck squamous cell carcinoma. Otolarygol Clin North Am. 1998 Aug;31(4):727-54.
Fritz A, Percy C, Jack A, Shanmugaratmam K, Sobin L, arkin DM, et al. editors. International Classification of Diseases for Oncology (ICD-O). 3rd ed. Geneva: WHO; 2000.
Zong. J, Lin S, Lin. J, Tang L, Chen B, Zhang M, et al. Impact of intensitymodulated radiotherapy on nasopharyngeal carcinoma: Validation of the 7th edition AJCC staging system. Oral Oncol. 2015 Mar;51(3):254-9. doi: 10.1016/j.oraloncology.2014.10.012.
Warnakulasuriya S. Global epidemiology of oral and oro-pharyngeal cancer. Oral Oncol. 2009 Apr-May;45(4-5):309-16. doi: 10.1016/j. oraloncology.2008.06.002.
Onyango JF, Awange DO, Njiru A, Macharia IM. Pattern of occurrence of head and neck cancer presenting at Kenyatta National Hospital, Nairobi. East Afr Med J. 2006 May;83(5):288-91.
Carvalho AL, Pintos J, Schlecht NF, Oliveira BV, Fava SA, Curado MP, et al. Predictive factors for diagnosis of advanced-Stage squamous Cell carcinoma of the Head and Neck. Arch otolaryngol Head Neck Surg. 2002 Mar;128(3):313-8.
Kerdpon D, Sriplung H. Factors related to delay in diagnosis of oral squamous cell carcinoma in southern Thailand. Oral Oncol. 2001 Feb;37(2):127-31.
Kolude B, Adisa A, Adeyemi B, Lawal A. Stages of delay in Oral cancer care evaluated at a tertiary health centre. Afr. J.Med.med Sci. 2013 Dec;42(4):347-53.
Issacs JJ, Mancuso AA, Mendenhall WM, Parsons JT. Deep spread patterns in CT staging of T2-4 squamous cell laryngeal carcinoma. Otolaryngol Head Neck Surg. 1988 Nov;99(5):455-64.
Gatenby RA, Mulhern CB, Strawitz J, Moldofsky PJ. Comparison of clinical and CT staging of head and neck tumors. AJNR Am J Neuroradiol. 1985 May-Jun;6(3):399-401.
Dillon WP, Harnsberger HR. The impact of radiologic imaging on staging of cancer of the head and neck. Semin Oncol.1991 Apr;18(2):64-79.
Berker M. Neoplastic invasion of laryngeal cartilage: radiologic diagnosis and therapeutic implications. Eur. J Radiol. 2000 Mar;33(3):216-29.
Prehn RB, Pasic TR, Harari PM, Brown WD, Ford CN. Influence of computed tomography on pre-therapeutic tumor staging in head and neck cancer patients. Otolaryngol Head Neck Surg. 1998 Dec;119(6): 628-33.
King AD, Tse GM, Yuen EH, To EW, Vlantis AC, Zee B, et al. Comparison of CT and MR imaging for the detection of extra-nodal neoplastic spread in metastatic neck nodes. Eur J Radiol. 2004 Dec;52(3):264-70.
Sakai O, Curtin HD, Romo LV, Som PM. Lymph node pathology. Benign proliferative. Radiol Clin N Am. 2000 Sep;38(5):979–98.
Dillon WP. Magnetic resonance imaging of head and neck tumors. Cardiovasc Intervent Radiol. 1986;8(5-6):275-82.
Branstetter BF, Blodgett TM, Zimmer LA, Snyderman CH, Johnson JT, Raman S, et al. Head and Neck Malignancy: Is PET/CT More Accurate than PET or CT Alone? Radiology. 2005 May;235(2):580-6.
Anand N, Chaudhary N, Mittal M.K, Prasad R. Comparison of the efficacy of clinical examination, ultrasound neck and computed tomography in detection and staging of cervical lymph node metastasis in head and neck cancers. Indian J Otolaryngol Head Neck Surg. 2007 Mar;59(1):19-23. doi: 10.1007/s12070-007-0005-6.
Krestan C, Herneth AM, Formanek M, Czerny C. Modern imaging lymph node staging of the Head and Neck region. Eur J Radiol. 2006 Jun;58(3):360-6.
de Bree R, Deurloo EE, Snow GB, Leemans CR. Screening for distant metastasis in patients with head and neck cancer. Laryngoscope. 2000 Mar;110(3 Pt1):397-401.
Conley BA. Treatment of advanced head and neck cancer: what lessons have we learned? J Clin Oncol. 2006 Mar;24(7):1023-5.
Petralia G, Preda L, Giugliano G, Jereczek-Fossa BA, Rocca A, D'Andrea G, et al. Perfusion computed tomography for monitoring induction chemotherapy with squamous cell carcinoma of the upper aero digestive tract: correlation between changes in tumor perfusion and tumor volume. J Comput Assist Tomogr. 2009 Jul-Aug;33(4):552-9. doi: 10.1097/RCT.0b013e31818d446e.
Soyannwo SO. How to make a difference in the Developing World: Organizing Resources. In: Paice JA, Bell RF, Kalso EA, Soyannwo OA., editors. Cancer Pain from Molecules to suffering. IASP Press; 2010. p.333-45.
Nensa F,Beiderwellen K, Heusch P, Wette A. Clinical applications of PET/MRI: current status and future Perspectives. Diagn Interv Radiol. 2014 Sep-Oct;20(5):438-47. doi: 10.5152/dir.2014.14008.
Shah GV, Wesolowski JR, Ansari SA, Mukherji SK. New directions in head and neck imaging. J Surg Oncol. 2008 Jun 15;97(8):644-8. doi: 10.1002/jso.21022.
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