Abstract：
OBJECTIVE: The aims of our study are to evaluate the diagnostic performance and prognostic value of radiological lymph node (LN) characteristics in pN+ oral cavity squamous carcinoma (OSCC).
METHODS: pN+ OSCC treated between 2012 and 2020 were included. Preoperative imaging was reviewed by a single radiologist blinded to pathologic findings for the following nodal features: imaging-positive LN (iN+), laterality and total number, and image-identified extranodal extension (iENE). The sensitivity of iN+ for pN+ was calculated. The diagnostic performance of other nodal features was evaluated in the iN+ subgroup. The association of radiologic nodal features with overall survival (OS) was evaluated. Inter-rater kappa for radiologic nodal features was assessed in 100 randomly selected cases.
RESULTS: Of 406 pN+ OSCC, 288 were iN+. The sensitivity of iN+ for pN+ was 71% overall, and improved to 89% for pN+ LN >1.5 cm. Within iN+, sensitivity/specificity for LN size (>3 cm), total LN number (>4), and ENE were 0.44/0.95, 0.57/0.84, and 0.27/0.96, respectively. Sensitivity of iENE was higher in the subset, with major (>2 mm) versus minor (≤2 mm) pENE (43% vs. 13%, p = 0.001). Reduced OS was observed in iN+ versus iN- (p = 0.006), iENE+ versus iENE- (p = 0.004), LN size >3 versus ≤3 cm (p < 0.001), and higher LN number (p < 0.001). Inter-rater kappa for iN+, laterality, total LN number, and presence of iENE were 0.71, 0.57, 0.78, and 0.69, respectively.
CONCLUSIONS: Our study shows that despite modest sensitivity of most radiological nodal features, the specificity of image-identified nodal features is high and their prognostic values are retained in pN+ OSCC.
METHODS: Level 3 (retrospective review comparing cases and controls) Laryngoscope, 2024.
METHODS: pN+ OSCC treated between 2012 and 2020 were included. Preoperative imaging was reviewed by a single radiologist blinded to pathologic findings for the following nodal features: imaging-positive LN (iN+), laterality and total number, and image-identified extranodal extension (iENE). The sensitivity of iN+ for pN+ was calculated. The diagnostic performance of other nodal features was evaluated in the iN+ subgroup. The association of radiologic nodal features with overall survival (OS) was evaluated. Inter-rater kappa for radiologic nodal features was assessed in 100 randomly selected cases.
RESULTS: Of 406 pN+ OSCC, 288 were iN+. The sensitivity of iN+ for pN+ was 71% overall, and improved to 89% for pN+ LN >1.5 cm. Within iN+, sensitivity/specificity for LN size (>3 cm), total LN number (>4), and ENE were 0.44/0.95, 0.57/0.84, and 0.27/0.96, respectively. Sensitivity of iENE was higher in the subset, with major (>2 mm) versus minor (≤2 mm) pENE (43% vs. 13%, p = 0.001). Reduced OS was observed in iN+ versus iN- (p = 0.006), iENE+ versus iENE- (p = 0.004), LN size >3 versus ≤3 cm (p < 0.001), and higher LN number (p < 0.001). Inter-rater kappa for iN+, laterality, total LN number, and presence of iENE were 0.71, 0.57, 0.78, and 0.69, respectively.
CONCLUSIONS: Our study shows that despite modest sensitivity of most radiological nodal features, the specificity of image-identified nodal features is high and their prognostic values are retained in pN+ OSCC.
METHODS: Level 3 (retrospective review comparing cases and controls) Laryngoscope, 2024.
摘要：
目的：我们的研究目的是评估pN+口腔鳞状细胞癌（OSCC）的放射学淋巴结（LN）特征的诊断性能和预后价值。
方法：纳入2012年至2020年治疗的pN+OSCC。术前影像学由一名放射科医师审查，该医师对以下淋巴结特征的病理发现不知情：成像阳性LN（iN），侧向性和总数，和图像识别的结外延伸（IENE）。计算iN+对pN+的灵敏度。在iN+亚组中评估其他淋巴结特征的诊断性能。评估了放射学淋巴结特征与总生存期（OS）的关联。在100例随机选择的病例中评估了放射学淋巴结特征的评分者kappa。
结果：406pN+OSCC，288分别为iN+。iN+对pN+的总体敏感性为71%,对于pN+LN>1.5cm，提高到89%。在iN+内,LN大小（>3cm）的敏感性/特异性，总LN数(>4)，和ENE分别为0.44/0.95、0.57/0.84和0.27/0.96。亚组中iENE的敏感性较高，主要(>2毫米)与次要(≤2毫米)PENE(43%与13%,p=0.001)。在iN+和iN-中观察到OS降低(p=0.006)，iENE+与iENE-（p=0.004），LN尺寸>3与≤3cm（p<0.001），和更高的LN数(p<0.001)。iN+的Inter-raterkappa，偏侧性,LN总数,和iENE的存在分别为0.71、0.57、0.78和0.69。
结论：我们的研究表明，尽管大多数放射学淋巴结特征的敏感性不高，图像识别的结节特征的特异性很高，其预后价值保留在pN+OSCC中。
方法：3级（回顾性回顾比较病例和对照）喉镜，2024.
方法：纳入2012年至2020年治疗的pN+OSCC。术前影像学由一名放射科医师审查，该医师对以下淋巴结特征的病理发现不知情：成像阳性LN（iN），侧向性和总数，和图像识别的结外延伸（IENE）。计算iN+对pN+的灵敏度。在iN+亚组中评估其他淋巴结特征的诊断性能。评估了放射学淋巴结特征与总生存期（OS）的关联。在100例随机选择的病例中评估了放射学淋巴结特征的评分者kappa。
结果：406pN+OSCC，288分别为iN+。iN+对pN+的总体敏感性为71%,对于pN+LN>1.5cm，提高到89%。在iN+内,LN大小（>3cm）的敏感性/特异性，总LN数(>4)，和ENE分别为0.44/0.95、0.57/0.84和0.27/0.96。亚组中iENE的敏感性较高，主要(>2毫米)与次要(≤2毫米)PENE(43%与13%,p=0.001)。在iN+和iN-中观察到OS降低(p=0.006)，iENE+与iENE-（p=0.004），LN尺寸>3与≤3cm（p<0.001），和更高的LN数(p<0.001)。iN+的Inter-raterkappa，偏侧性,LN总数,和iENE的存在分别为0.71、0.57、0.78和0.69。
结论：我们的研究表明，尽管大多数放射学淋巴结特征的敏感性不高，图像识别的结节特征的特异性很高，其预后价值保留在pN+OSCC中。
方法：3级（回顾性回顾比较病例和对照）喉镜，2024.
