Assessment of carotid artery invasion by lymph node metastasis from squamous cell carcinoma of aero-digestive tract.
Carotid involvement by metastatic lymph nodes changes the approach in head and neck tumors.


OBJECTIVE
To evaluate interobserver agreement by CT scan analysis regarding the involvement of the carotid artery by metastatic lymph nodes from squamous cell carcinoma of the upper aerodigestive tract and its relation to resection criteria.


METHODS
retrospective study of 99 CT images of patients with SCC were evaluated. Eighty-six were males and 13 females, with ages ranging from 32 to 76 years. Four radiologists, without any previous knowledge of the clinical stage, analyzed imaging results. No patients had received previous treatment and histological diagnoses were obtained through biopsy. The carotid artery invasion was classified as simple (0 to 50% and from to 100%), and complex (0 to 25%; 26 to 50%; 51 to 75% and 76 to 100%). The level of interobserver agreement was obtained through Kappa Index (p < 0,05) and the concordance power varied from despicable to excellent.


RESULTS
The Kappa Index were moderate (0, 53%) for simple classification and minimum (0, 36%) for complex classification.


CONCLUSIONS
The computed tomography showed low effectiveness in the evaluation of lymph node metastasis resection concerning carotid artery invasion.
Rapoport
Abrão
A
Dept Saúde, Hospital Heliópolis, SP, Brazil. arapoport@terra.com.br
Tornin
Olger de Souza
Ode S
Beserra Júnior
Ivo Marques
IM
Carvalho Neto
Paulo Bentes de
PB
Souza
Ricardo Pires de
RP
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D002339:Carotid Arteries / Q000473:pathology* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed