The value of chest CT scan in the work-up of head and neck cancers.
The systemic work-up of patients with head and neck cancers includes a routine chest x-ray and panendoscopy. In patients with a high risk for head and neck cancers, such as heavy smokers and drinkers, a high incidence of second upper aerodigestive tract tumors is expected, in addition to the risk of metastatic spread from their primary neoplasm. In this study, we evaluated the contribution of a chest CAT in patients with negative plain chest x-rays. Twenty-four consecutive patients with head and neck cancers were entered. All patients had locally advanced disease. Nine of the 24 patients (37.5%) had positive findings on their chest CAT scans. All lesions detected by CAT, except for one, were biopsied and reported as squamous cell carcinomas. All these patients had T3 and T4 lesions and only one was N0. Three of these lesions were considered to be metastatic and four more were believed to be second primary lung tumors. In two patients, the nature of the lesions was not determined. In conclusion, because of the high incidence of positive lung CAT scans in this group of patients, we recommend a chest CAT for work-up prior to initiating any definitive therapy for their head and neck cancers.
Halpern
J
J
Division of Radiation Oncology, University of Medicine and Dentistry of New Jersey, Newark 07103, USA.
D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging*; D006801:Humans; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed