Follow-up ultrasonography for late neck metastases of head and neck cancer.
Ultrasonographic examinations to detect late cervical lymph node metastases were performed at follow-up examinations for 52 patients with head and neck cancer who had not received neck dissection. Using diagnostic criteria we established previously, we accurately diagnosed 24 nodes in 10 patients as late metastases; 21 of these were nonpalpable. Of 12 nodes in 8 patients that were diagnosed as nonmetastatic using ultrasound (US) before radical treatment of the primary tumor, 11 showed an increase in the minimal diameter, 9 showed an internal echo pattern shift from homogeneous to heterogeneous and, in 7, the echogenic hilus changed from present to absent. A diagnostic equation was used to calculate a predictive value lambda for 146 nodes. Of these, 5 of 25 with a lambda value of -1 <or= lambda, and 7 of 121 with a lambda value of < -1 were late neck metastases. The incidence of late metastasis was significantly higher in nodes whose value was -1 <or= lambda. Thus, US examination appears useful for the follow-up of cervical lymph nodes in patients with oral and maxillofacial cancer.
Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan. y-yusa@md.tsukuba.ac.jp
Hiroshi
H
Yusa
Hiroshi
H
Yoshida
Ei
E
Ueno
Kenji
K
Yamagata
Kojiro
K
Onizawa
Toru
T
Yanagawa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000556:secondary*; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D018307:Neoplasms, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary*; D012189:Retrospective Studies; D014463:Ultrasonography