Comparative analysis of clinical and pathological lymph node staging data in head and neck squamous cell carcinoma patients treated at the General Hospital Vienna

Characteristic	abs. (rel.) 87 (100)
Age (mean/median) years	58.4/59.0
Male	67 (77.0)
Female	20 (23.0)
Primary tumour site
Oropharynx	33 (37.9)
Oral cavity	30 (34.5)
Larynx	9 (10.3)
Hypopharynx	15 (17.2)
Localization
right	42 (48.3)
left	40 (46.0)
midline	5 (5.7)

Table 1B

Pre- and postoperative staging results.

Stage	Pathological staging	Clinical staging	p-value
T
1	19 (21.8)	19 (21.8)	0.000a
2	42 (48.3)	34 (39.1)
3	14 (16.1)	19 (21.8)
4	12 (13.8)	15 (17.2)
N
0	21 (24.1)	17 (19.5)	0.000a
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)
UICC
I	4 (4.6)	2 (2.3)	0.000a
II	12 (13.8)	6 (6.9)
III	11 (12.6)	17 (19.5)
IV	60 (69)	62 (71.3)

a Pearson correlation (significance 2-tailed). Correlations are significant below the 0.01 level

Table 1C

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	21
pN1	13	2	15
pN2a	2	0	2
pN2b	32	2	34
pN2c	13	0	13
pN3	2	0	2
Total	77	10	87
cN0	14	3	17
cN1	11	4	15
cN2a	6	0	6
cN2b	21	3	24
cN2c	25	0	25
Total	77	10	87

Kaplan Meier curves for the complete patient group (A) and according to primary tumour sites (B).
Hyp = hypopharyngeal carcinoma; Lar = laryngeal carcinoma; Oc = oral cavity carcinoma; Oroph = oropharyngeal carcinoma

Table 2A

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%)

Table 2B

Concordance of pathological and clinical findings according to N stage

Clinical stage			Pathological stage
N = 87	pN0	pN1	pN2a	pN2b	pN2c	pN3
cN0 (N = 17)	11	3	0	1	2	0
cN1 (N = 15)	4	6	0	3	2	0
cN2a (N = 6)	1	2	1	2	0	0
cN2b (N = 24)	3	2	0	18	1	0
cN2c (N = 25)	2	2	1	10	8	2
cN3 (N = 0)	0	0	0	0	0	0

Table 3A

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%)

Table 3B

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
LII	Sig.	0.791	1
LIII	Corr.	0.040	0.325a	1
LIII	Sig.	0.711	0.001	1
LIV	Corr.	-0.069	0.113	0.449a	1
LIV	Sig.	0.524	0.297	0.000	1
LV	Corr.	-0.139	0.088	0.145	0.427a	1
LV	Sig.	0.198	0.419	0.182	0.000	1

a Pearson correlation (significance 2-tailed). Correlations are significant below the 0.01 level.

Table 4

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
Down-staging according to pN status n = 10 (11.5%)
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
Up-staging according to pN status N = 9 (10.3%)
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

References

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Articles in this issue

DOI: https://doi.org/10.2478/raon-2018-0020 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 173 - 180

Submitted on: Jan 29, 2018

Accepted on: Apr 4, 2018

Published on: May 11, 2018

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

lymph node staging,

head and neck squamous cell cancer,

Related subjects:

© 2018 Christina Eder-Czembirek, Birgit Erlacher, Dietmar Thurnher, Boban M. Erovic, Edgar Selzer, Michael Formanek, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 52 (2018): Issue 2 (June 2018)

Comparative analysis of clinical and pathological lymph node staging data in head and neck squamous cell carcinoma patients treated at the General Hospital Vienna

Figures & Tables

Table 1A