[Comparision of Clinical Versus Histopathological Staging in Patients with Oropharyngeal Carcinoma]
Stephan Knipping1, Anika Theunert2, Karsten Stock3
1Klinik für Hals-, Nasen- und Ohrenheilkunde, Kopf- und Halschirurgie, Plastische Operationen, Städtisches Klinikum Dessau, Dessau.
Abstract:
Despite all the progress in clinical diagnostics and multimodal therapy, the prediction of oropharyngeal carcinoma remains to be limited. Therefore, it is important to further improve clinical staging to set therapy modalities based on that.In a retrospective pseudonymized study over a 13 years period of time the clinical classification (cTNM) was compared with the histopathologic classification (pTNM) of 84 patients with oropharyngeal squamous cell carcinoma and who were treated primarily with surgery. Furthermore, the existence of occult metastases as well as overall survival as a function of histopathologic extent of the tumor and regional infestation of lymph nodes were considered.The highest agreement between cTNM and pTNM was observed with computer tomography. A definite evaluation with histopathological reliability is not possible with cTNM. MRT examinations showed the tendency to estimate T -, N- and UICC-stage compared with the histopathologic findings. In the context of the examinations of survival probabilities, separated by sex and histopathologic T- and N-categories, a lower overall survival probability was seen for the higher T- and N-category.Despite all the progress in imaging diagnostics for patients with oropharyngeal carcinoma the cTNM, compared with pTNM, is only partially able to determine the TNM classification of the cancer with requested clinical accuracy. With the trend of decreasing predictions and in spite of present-day multimodal therapy it is essential to improve and optimize the pre-therapeutic clinical staging.
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