Computed tomography in TN stage evaluation of oral cavity and oropharyngeal cancers

Oral and oropharyngeal carcinomas are characterized by a high incidence of node metastatic involvement and local extension. The study compared the TN stage of patients by clinical and computed tomography (CT) examination to postoperative histopathology. Sensitivity of CT for tumor extension was 82%, predictive value for bone involvement 67%. Clinical examination was poor in predicting the presence (54%) or absence (56%) of node involvement. Sensitivity of CT for assessment of node involvement was 80%, specificity 71%, positive predictive value 67%, and negative 83%. Node involvement was high (30%) in clinically NO necks versus only 9% for negative CT.