Ultrasound-guided aspiration cytology for the assessment of the clinically N0 neck: Factors influencing its accuracy

✍ Scribed by Maarten C. Borgemeester; Michiel W. M. van den Brekel; Harm van Tinteren; Ludi E. Smeele; Frank A. Pameijer; Marie-Louise F. van Velthuysen; Alfons J. M. Balm

• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 150 KB
• Volume: 30
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.20903

✦ Synopsis

Abstract

Background.

Ultrasound‐guided fine‐needle aspiration cytology (US‐FNAC) can be used to diminish the risk of missing occult metastases and for early detection during follow‐up.

Methods.

A retrospective study was performed in 163 surgically treated patients without palpable neck nodes (N0). One hundred twenty‐six patients underwent planned elective neck dissections, and 37 were planned for a wait‐and‐see strategy, but preoperative US‐FNAC could change this policy if metastases were detected.

Results.

In the elective neck dissection group, US‐FNAC had a sensitivity of 39%, whereas in the wait‐and‐see group, the sensitivity was 18%. The 5‐year survival in the wait‐and‐see group did not differ from the patients with early oral cancer who underwent an elective neck dissection.

Conclusion.

Although the sensitivity of US‐FNAC in this study is low, especially in small oral cancer, the prognosis in the wait‐and‐see group is not affected. However, a wait‐and‐see strategy is only advantageous to a minority of the patients. © 2008 Wiley Periodicals, Inc. Head Neck, 2008