title: Ultrasound-guided aspiration cytology for the assessment of the clinically N0 neck: factors influencing its accuracy.
abstract: BACKGROUND
  Ultrasound-guided fine-needle aspiration cytology (US-FNAC) can be used to diminish the risk of missing occult metastases and for early detection during follow-up.
  
  
  METHODS
  A retrospective study was performed in 163 surgically treated patients without palpable neck nodes (N0). One hundred twenty-six patients underwent planned elective neck dissections, and 37 were planned for a wait-and-see strategy, but preoperative US-FNAC could change this policy if metastases were detected.
  
  
  RESULTS
  In the elective neck dissection group, US-FNAC had a sensitivity of 39%, whereas in the wait-and-see group, the sensitivity was 18%. The 5-year survival in the wait-and-see group did not differ from the patients with early oral cancer who underwent an elective neck dissection.
  
  
  CONCLUSIONS
  Although the sensitivity of US-FNAC in this study is low, especially in small oral cancer, the prognosis in the wait-and-see group is not affected. However, a wait-and-see strategy is only advantageous to a minority of the patients.
authors.affiliation: Department of Head and Neck Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Maarten C
authors.initials: MC
authors.lastname: Borgemeester
authors.forename: Michiel W M
authors.initials: MW
authors.lastname: van den Brekel
authors.forename: Harm
authors.initials: H
authors.lastname: van Tinteren
authors.forename: Ludi E
authors.initials: LE
authors.lastname: Smeele
authors.forename: Frank A
authors.initials: FA
authors.lastname: Pameijer
authors.forename: Marie-Louise F
authors.initials: ML
authors.lastname: van Velthuysen
authors.forename: Alfons J M
authors.initials: AJ
authors.lastname: Balm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000556:secondary* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D018084:Ultrasonography, Interventional