Comparative analysis of clinical and pathological lymph node staging data in head and neck squamous cell carcinoma patients treated at the General Hospital Vienna
, , , , and | May 11, 2018
About this article
Article Category: Research Article
Published Online: May 11, 2018
Page range: 173 - 180
Received: Jan 29, 2018
Accepted: Apr 04, 2018
DOI: https://doi.org/10.2478/raon-2018-0020
© 2018 Christina Eder-Czembirek, Birgit Erlacher, Dietmar Thurnher, Boban M. Erovic, Edgar Selzer, Michael Formanek, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Figure 1
Prevalence of regional lymph node involvement according to tumour site
| Primary tumour localization | |||||
|---|---|---|---|---|---|
| Lymph Node Level | Hypopharynx (n = 15) | Larynx (n = 9) | Oral cavity (n = 30) | Oropharynx (n = 33) | % of total collective |
| I | 2 (13.3%) | 1 (11.1%) | 5 (16.7%) | 6 (18.2%) | 14 (16.1%) |
| II | 8 (53.3%) | 4 (44.4%) | 22 (73.3%) | 18 (54.4%) | 52 (59.8%) |
| III | 3 (20%) | 4 (44.4%) | 13 (43.3%) | 15 (45.5%) | 35 (40.2%) |
| IV | 4 (26.7%) | 2 (22.2%) | 7 (23.3%) | 5 (15.2%) | 18 (20.7%) |
| V | 2 (13.3%) | 1 (11.1%) | 4 (13.3%) | 1 (3%) | 8 (9.2%) |
Clinical and pathological lymph node staging results in relation to the type of neck dissection performed.
| Stage | Bilateral neck dissection | Unilateral neck dissection | Total |
|---|---|---|---|
| pN0 | 15 | 6 | |
| pN1 | 13 | 2 | |
| pN2a | 2 | 0 | |
| pN2b | 32 | 2 | |
| pN2c | 13 | 0 | |
| pN3 | 2 | 0 | |
| cN0 | 14 | 3 | |
| cN1 | 11 | 4 | |
| cN2a | 6 | 0 | |
| cN2b | 21 | 3 | |
| cN2c | 25 | 0 | |
Statistical analysis of the correlation of involvement of adjacent lymphnode levels
| N = 87 | LI | LII | LIII | LIV | LV | |
|---|---|---|---|---|---|---|
| LI | Corr. | 1 | ||||
| LII | Corr. | 0.029 | 1 | |||
| Sig. | 0.791 | |||||
| LIII | Corr. | 0.040 | 0.325 Pearson correlation (significance 2-tailed). Correlations are significant below the 0.01 level. |
1 | ||
| Sig. | 0.711 | 0.001 | ||||
| LIV | Corr. | -0.069 | 0.113 | 0.449 Pearson correlation (significance 2-tailed). Correlations are significant below the 0.01 level. |
1 | |
| Sig. | 0.524 | 0.297 | 0.000 | |||
| LV | Corr. | -0.139 | 0.088 | 0.145 | 0.427 Pearson correlation (significance 2-tailed). Correlations are significant below the 0.01 level. |
1 |
| Sig. | 0.198 | 0.419 | 0.182 | 0.000 | ||
Pre- and postoperative staging results.
| Stage | Pathological staging | Clinical staging | p-value | |
|---|---|---|---|---|
| 1 | 19 (21.8) | 19 (21.8) | 0.000 Pearson correlation (significance 2-tailed). Correlations are significant below the 0.01 level |
|
| 2 | 42 (48.3) | 34 (39.1) | ||
| 3 | 14 (16.1) | 19 (21.8) | ||
| 4 | 12 (13.8) | 15 (17.2) | ||
| 0 | 21 (24.1) | 17 (19.5) | 0.000 Pearson correlation (significance 2-tailed). Correlations are significant below the 0.01 level |
|
| 1 | 15 (17.2) | 15 (17.2) | ||
| 2a | 2 (2.3) | 6 (6.9) | ||
| 2b | 34 (39.1) | 24 (27.6) | ||
| 2c | 13 (14.9) | 25 (28.7) | ||
| 3 | 2 (2.3) | 0 (0) | ||
| I | 4 (4.6) | 2 (2.3) | 0.000 Pearson correlation (significance 2-tailed). Correlations are significant below the 0.01 level |
|
| II | 12 (13.8) | 6 (6.9) | ||
| III | 11 (12.6) | 17 (19.5) | ||
| IV | 60 (69) | 62 (71.3) |
Discrepancies of pathological and clinical findings according to imaging type
| Number of discrepant results per patient | CT (n = 55) | MRI (n = 21) | CT/MRI (n = 11) | Total (n = 87) |
|---|---|---|---|---|
| 0 | 43.6% | 38.1% | 36.4% | 36 (41.4%) |
| 1 | 25.5% | 23.8% | 45.5% | 24 (27.6%) |
| 2 | 18.2% | 23.8% | 9.1% | 16 (18.4%) |
| 3 | 5.5% | 9.5% | 0.0% | 5 (5.7%) |
| 4 | 7.3% | 4.8% | 0.0% | 5 (5.7%) |
| 5 | 0.0% | 0.0% | 9.1% | 1 (1.1%) |
Patient characteristics.
| Characteristic | abs. (rel.) 87 (100) |
|---|---|
| 58.4/59.0 | |
| 67 (77.0) | |
| 20 (23.0) | |
| Oropharynx | 33 (37.9) |
| Oral cavity | 30 (34.5) |
| Larynx | 9 (10.3) |
| Hypopharynx | 15 (17.2) |
| right | 42 (48.3) |
| left | 40 (46.0) |
| midline | 5 (5.7) |
Concordance of pathological and clinical findings according to N stage
| Clinical stage | Pathological stage | |||||
|---|---|---|---|---|---|---|
| N = 87 | pN0 | pN1 | pN2a | pN2b | pN2c | pN3 |
| 11 | 3 | 0 | 1 | 2 | 0 | |
| 4 | 6 | 0 | 3 | 2 | 0 | |
| 1 | 2 | 1 | 2 | 0 | 0 | |
| 3 | 2 | 0 | 18 | 1 | 0 | |
| 2 | 2 | 1 | 10 | 8 | 2 | |
| 0 | 0 | 0 | 0 | 0 | 0 | |
List of all cases associated with up- or down-staging according to the preand postoperative regional lymph-node status
| No. | cT | cN | Overall clinical stage | pT | pN | Overall pathological stage |
|---|---|---|---|---|---|---|
| 1 | 2 | 1 | III | 1 | 0 | I |
| 2 | 1 | 2a | IV | 1 | 0 | I |
| 3 | 2 | 2b | IV | 1 | 0 | I |
| 4 | 2 | 1 | III | 2 | 0 | II |
| 5 | 2 | 1 | III | 2 | 0 | II |
| 6 | 2 | 2b | IV | 2 | 0 | II |
| 7 | 1 | 2b | IV | 2 | 0 | II |
| 8 | 3 | 2c | IV | 2 | 0 | II |
| 9 | 3 | 2b | IV | 2 | 1 | III |
| 10 | 2 | 2c | IV | 2 | 1 | III |
| 1 | 2 | 0 | II | 2 | 1 | III |
| 2 | 3 | 0 | III | 4 | 1 | IV |
| 3 | 2 | 1 | III | 2 | 2b | IV |
| 4 | 2 | 1 | III | 2 | 2b | IV |
| 5 | 3 | 0 | III | 3 | 2b | IV |
| 6 | 2 | 1 | III | 2 | 2b | IV |
| 7 | 2 | 1 | III | 3 | 2c | IV |
| 8 | 1 | 0 | I | 1 | 2c | IV |
| 9 | 1 | 2b | III | 1 | 2c | IV |