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FDG-PET in the clinically negative neck in oral squamous cell carcinoma
Bart M Wensing1, Wouter V Vogel, Henri A M Marres
1Department of Otorhinolaryngology and Head & Neck Surgery, Radboud University Nijmegen Medical Centre, The Netherlands. b.wensing@kno.umcn.nl
Objective:
With improved diagnostic imaging techniques, it remains difficult to reduce occult metastatic disease in oral squamous cell carcinoma (SCC) to less than 20%. Therefore, supraomohyoid neck dissection (SOHND) still is a valuable staging procedure in these patients.
Methods:
Patients with clinically and ultrasonographically staged cN0 SCC of the oral cavity underwent FDG-PET before SOHND. Histologic examination of neck dissection specimens was used as a "gold standard."
Results:
Twenty-eight consecutive patients were included, representing 30 necks. Occult metastatic disease was found in 30% of SOHND specimens. Average diameter of metastatic deposits was 4.3 mm. Sensitivity, specificity, and accuracy of FDG-PET was 33%, 76%, and 63%, respectively.
Conclusions:
In patients with cN0 SCC of the oral cavity, FDG-PET does not contribute to the preoperative workup. FDG-PET does not replace SOHND as a staging procedure.
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