Artikel
Influence of improved imaging techniques on detection of occult cervical lymph node metastases
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Autoren
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Frank Waldfahrer
- Department of Otorhinolaryngology, Head and Neck Surgery, Erlangen, Germany
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Claudia Scherl
- Department of Otorhinolaryngology, Head and Neck Surgery, Erlangen, Germany
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Johannes Zenk
- Department of Otorhinolaryngology, Head and Neck Surgery, Erlangen, Germany
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Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Erlangen, Germany
| Veröffentlicht: | 22. Juli 2009 |
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Gliederung
Text
Before sonography and computed tomography had been established, cervical nodes were only assessed by clinical examination. Since the nineties imaging is used in a routine matter. In this retrospective study we analyzed if introduction of imaging could change the rate of occult lymph node metastases.
517 patients treated between 1976 and 2005 with cancer of the oral cavity, oropharynx, hypopharynx, and larynx and cN0 neck, underwent uni- or bilateral elective neck dissection. Patients with recurrences or preoperative radiation therapy were excluded from this study.
The rate of occult cervical lymph node metastases was 27.8% for the whole group. Between 1976–1985 (only palpation) the rate was 28.5%, between 1986–1995 (increasing use of imaging) 27.2% and between 1996–2006 (imaging as routine procedure) 29.6%. However, the diameter of the occult metastases decreased when imaging was used.
It is to conclude, that the introduction of imaging techniques in staging of the neck could not influence the rate of occult metastases at all. Therefore elective neck dissection should be performed with liberal indication.
