{Reference Type}: Journal Article
{Title}: Radiology-Pathology Concordance and Prognostication of Nodal Features in pN+ Oral Cavity Cancer.
{Author}: Duguet-Armand M;Su J;O'Sullivan B;de Almeida J;Hosni A;Weinreb I;Perez-Ordonez B;Smith S;Witterick I;Yao C;Goldstein D;Hope A;Hahn E;Waldron J;Ringash J;Spreafico A;Yu E;Huang SH;
{Journal}: Laryngoscope
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 14
{Factor}: 2.97
{DOI}: 10.1002/lary.31578
{Abstract}: <B>OBJECTIVE: </B>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).<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.<BR><B>METHODS: </B>Level 3 (retrospective review comparing cases and controls) Laryngoscope, 2024.