Eder-Czembirek Christina, Erlacher Birgit, Thurnher Dietmar, Erovic Boban M, Selzer Edgar, Formanek Michael
Department of Cranio-, Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
Department of Otorhinolaryngology and Phoniatry, Hospital St. John of God and Vienna Sigmund Freud University (Medical Faculty), Vienna, Austria.
Radiol Oncol. 2018 May 11;52(2):173-180. doi: 10.2478/raon-2018-0020. eCollection 2018 Jun.
Results from publications evaluating discrepancies between clinical staging data in relation to pathological findings demonstrate that a significant number of head and neck squamous cell carcinoma (HNSCC) patients are not correctly staged. The aim of this retrospective study was to analyze potential discrepancies of radiological assessment versus pathological data of regional lymph node involvement and to compare the results with data published in the literature.
In a retrospective analysis we focused on patients with HNSCC routinely treated by surgery plus postoperative radiotherapy between 2002 and 2012. For inclusion, complete pre-operative clinical staging information with lymph node status and patho-histological information on involved lymph node regions as well as survival outcome data were mandatory. We included 87 patients (UICC stage III-IV 90.8%) for which the aforementioned data obtained by CT or MRI were available. Overall survival rates were estimated by the Kaplan-Meier method. The Pearson correlation coefficient and Spearman's rank correlation coefficient (non-linear relationship) was calculated.
Discrepancies at the level of overall tumour stage assessment were noticed in 27.5% of all cases. Thereof, 5.7% were assigned to patho-histological up-staging or down-staging of the primary tumour. At the lymph node level, 11.5% of the patients were downstaged, and 10.3% were upstaged.
The study showed that in approximately one-fifth (21.8%) of the patients, lymph node assessment by CT or MRI differs from the pathologic staging, an outcome that corresponds well with those published by several other groups in this field.
评估临床分期数据与病理结果之间差异的出版物结果表明，相当数量的头颈部鳞状细胞癌（HNSCC）患者分期不正确。这项回顾性研究的目的是分析区域淋巴结受累的放射学评估与病理数据之间的潜在差异，并将结果与文献中发表的数据进行比较。
在一项回顾性分析中，我们重点关注2002年至2012年间接受手术加术后放疗常规治疗的HNSCC患者。纳入标准为必须具备完整的术前临床分期信息（包括淋巴结状态）、受累淋巴结区域的病理组织学信息以及生存结局数据。我们纳入了87例患者（国际抗癌联盟III-IV期患者占90.8%），这些患者可获取通过CT或MRI获得的上述数据。采用Kaplan-Meier方法估计总生存率。计算Pearson相关系数和Spearman等级相关系数（非线性关系）。
在所有病例中，27.5%的病例在总体肿瘤分期评估水平上存在差异。其中，5.7%的病例被判定为原发肿瘤的病理组织学分期上调或下调。在淋巴结水平上，11.5%的患者分期下调，10.3%的患者分期上调。
该研究表明，在大约五分之一（21.8%）患者中，CT或MRI对淋巴结的评估与病理分期不同，这一结果与该领域其他几个研究小组发表的结果非常吻合。
