cTNM vs. pTNM: the effect of not applying ultrasonography in the identification of cervical nodal disease
Identifieur interne : 003C65 ( Ncbi/Curation ); précédent : 003C64; suivant : 003C66cTNM vs. pTNM: the effect of not applying ultrasonography in the identification of cervical nodal disease
Auteurs : Waseem Jerjes [Royaume-Uni, Iraq] ; Tahwinder Upile [Royaume-Uni] ; Hani Radhi [Iraq] ; Aviva Petrie [Royaume-Uni] ; Jesuloba Abiola [Royaume-Uni] ; Aidan Adams [Royaume-Uni] ; Jacqueline Callear [Royaume-Uni] ; Panagiotis Kafas [Grèce] ; Syedda Abbas [Royaume-Uni] ; Kartic Rajaram [Royaume-Uni] ; Colin Hopper [Royaume-Uni]Source :
- Head & Neck Oncology [ 1758-3284 ] ; 2012.
Abstract
Accurate clinical staging of oral squamous cell cancer can be quite difficult to achieve especially if nodal involvement is identified. Radiologically-assisted clinical staging is more accurate and informs the clinician of loco-regional and distant metastasis.
In this study, we compared clinical TNM (cTNM) staging (not including ultrasonography) to pathological TNM (pTNM) staging in 245 patients presenting with carcinoma of the oral cavity and the oro-pharyngeal region. Tumour size differences and nodal involvement were highlighted. US reports of the neck were then added to the clinical staging and results compared.
Tumour size was clinically underestimated in 4 T1, 2 T2 and 2 T3 oral diseases. Also 20 patients that were reported as nodal disease free had histological proven N1 or N2 nodal involvement; while 3 patients with cTNM showing N1 disease had histologically proven N2 disease.
Overall the agreement between the 2 systems per 1 site was 86.6% (Kappa agreement = 0.80), per 2 sites 90.0% (Kappa agreement = 0.68) and per 3 sites 90.5% (Kappa agreement 0.62).
An accurate clinical staging is of an utmost importance. It is the corner stone in which the surgical team build the surgical treatment plan and decide whether an adjuvant therapy is required to deal with any possible problem that might arise. The failure to achieve an accurate staging may lead to incomplete surgical planning and hence unforeseen problems that may adversely affect the patient's survival.
Url:
DOI: 10.1186/1758-3284-4-5
PubMed: 22410339
PubMed Central: 3351374
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<author><name sortKey="Petrie, Aviva" sort="Petrie, Aviva" uniqKey="Petrie A" first="Aviva" last="Petrie">Aviva Petrie</name>
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<author><name sortKey="Abiola, Jesuloba" sort="Abiola, Jesuloba" uniqKey="Abiola J" first="Jesuloba" last="Abiola">Jesuloba Abiola</name>
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<author><name sortKey="Callear, Jacqueline" sort="Callear, Jacqueline" uniqKey="Callear J" first="Jacqueline" last="Callear">Jacqueline Callear</name>
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<author><name sortKey="Kafas, Panagiotis" sort="Kafas, Panagiotis" uniqKey="Kafas P" first="Panagiotis" last="Kafas">Panagiotis Kafas</name>
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<author><name sortKey="Abbas, Syedda" sort="Abbas, Syedda" uniqKey="Abbas S" first="Syedda" last="Abbas">Syedda Abbas</name>
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<author><name sortKey="Rajaram, Kartic" sort="Rajaram, Kartic" uniqKey="Rajaram K" first="Kartic" last="Rajaram">Kartic Rajaram</name>
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<author><name sortKey="Hopper, Colin" sort="Hopper, Colin" uniqKey="Hopper C" first="Colin" last="Hopper">Colin Hopper</name>
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<series><title level="j">Head & Neck Oncology</title>
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<front><div type="abstract" xml:lang="en"><p>Accurate clinical staging of oral squamous cell cancer can be quite difficult to achieve especially if nodal involvement is identified. Radiologically-assisted clinical staging is more accurate and informs the clinician of loco-regional and distant metastasis.</p>
<p>In this study, we compared clinical TNM (cTNM) staging (not including ultrasonography) to pathological TNM (pTNM) staging in 245 patients presenting with carcinoma of the oral cavity and the oro-pharyngeal region. Tumour size differences and nodal involvement were highlighted. US reports of the neck were then added to the clinical staging and results compared.</p>
<p>Tumour size was clinically underestimated in 4 T1, 2 T2 and 2 T3 oral diseases. Also 20 patients that were reported as nodal disease free had histological proven N1 or N2 nodal involvement; while 3 patients with cTNM showing N1 disease had histologically proven N2 disease.</p>
<p>Overall the agreement between the 2 systems per 1 site was 86.6% (Kappa agreement = 0.80), per 2 sites 90.0% (Kappa agreement = 0.68) and per 3 sites 90.5% (Kappa agreement 0.62).</p>
<p>An accurate clinical staging is of an utmost importance. It is the corner stone in which the surgical team build the surgical treatment plan and decide whether an adjuvant therapy is required to deal with any possible problem that might arise. The failure to achieve an accurate staging may lead to incomplete surgical planning and hence unforeseen problems that may adversely affect the patient's survival.</p>
</div>
</front>
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