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Head Neck. 2015 Dec;37(12):1829-39. doi: 10.1002/hed.23814. Epub 2014 Sep 26.

Advances in diagnostic modalities to detect occult lymph node metastases in head and neck squamous cell carcinoma.

Author information

1
Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands.
2
Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
3
Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
4
Department of Otorhinolaryngology, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
5
Department of Otorhinolaryngology-Head and Neck Surgery, Kantonsspital, St. Gallen, Switzerland.
6
Department of Radiology, University of Florida College of Medicine, Gainesville, Florida.
7
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
8
Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
9
Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain.
10
Oral Pathology, School of Dentistry, University of Liverpool, Liverpool, United Kingdom.
11
Department of Otolaryngology-Head and Neck Surgery, University of Marburg, Marburg, Germany.
12
Department of Otolaryngology-Head and Neck Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida.
13
University of Udine School of Medicine, Udine, Italy.
14
Department of Surgery, Banner MD Anderson Cancer Center, Gilbert, Arizona.
15
Department of Head and Neck Surgery, Head and Neck Oncology Program, St. Luc University Hospital and Cancer Center, Brussels, Belgium.
16
Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois.
17
Departments of Surgery and Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York.

Abstract

Regional metastasis is a prominent feature of head and neck squamous cell carcinoma (HNSCC) and is an important prognostic factor. The currently available imaging techniques for assessment of the neck have limitations in accuracy; thus, elective neck dissection has remained the usual choice of management of the clinically N0 neck (cN0) for tumors with significant (≥20%) incidence of occult regional metastasis. As a consequence, the majority of patients without regional metastasis will undergo unnecessary treatment. The purpose of this review was to discuss new developments in techniques that potentially improve the accuracy of the assessment of the neck in patients with HNSCC. Although imaging has improved in the last decades, a limitation common to all imaging techniques is a lack of sensitivity for small tumor deposits. Therefore, complementary to improvements in imaging techniques, developments in more invasive diagnostic procedures, such as sentinel node biopsy (SNB) will add to the accuracy of diagnostic algorithms for the staging of the neck.

KEYWORDS:

diagnostic techniques; head and neck; lymph node metastasis; occult; squamous cell carcinoma

PMID:
24954811
DOI:
10.1002/hed.23814
[Indexed for MEDLINE]

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