CT for Estimating Adequacy of Lymph Node Dissection in Patients with Squamous Cell Carcinoma of the Head and Neck

Overview

Journal Cancer Imaging

Publisher Springer Nature

Specialties Oncology
Radiology

Date 2021 Nov 22

PMID 34802462

Authors

Christiaan A Rees

Joshua H Litchman

Xiaotian Wu

Mariah M Servos

Darcy A Kerr

Ryan J Halter

David A Pastel

Joseph A Paydarfar

Affiliations

Soon will be listed here.

Abstract

Background: Indices obtained from lymph node dissection specimens, specifically lymph node yield (LNY) and lymph node ratio (LNR), have prognostic significance in the setting of head and neck squamous cell carcinoma (HNSCCa). However, there are currently no validated tools to estimate adequacy of planned lymph node dissection using preoperative data. The present study sought to evaluate CT-derived estimates of lymphatic tissue volumes as a preoperative tool to guide cervical node dissection.

Methods: Fifteen cervical lymph node dissections were performed in 14 subjects with HNSCCa. Preoperative CT-derived estimates of lymphatic tissue volumes were compared with gross pathology tissue volume estimates and pathologically-determined LNY.

Results: Resected tissue volume (calculated using the triaxial ellipsoid method) correlates with CT-derived preoperative lymphatic volume estimates (r = 0.74, p = 0.003) while LNY does not(r = - 0.12, p = 0.67). When excluding pathologically enlarged lymph nodes ("refined" data), a negative correlation was observed between refined CT-derived volume estimates and refined LNY (r = - 0.65, p = 0.009).

Conclusion: In the setting of cervical lymph node dissection, CT-derived lymphatic volume estimates correlate with resected tissue volume, but refined CT-derived volume estimates correlate negatively with refined LNY.

Trial Registration: Retrospectively registered.

Level Of Evidence: 4.

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