A new method for the prediction of cervical node metastases in squamous cell carcinoma of the oral cavity: a combination of Martínez-Gimeno Scoring System and clinical palpation.
OBJECTIVE
Evaluation of the accuracy of palpation, CT scan and Martínez-Gimeno Score System in the assessment of neck nodes metastasis in squamous cell carcinoma of the oral cavity.


METHODS
This is a prospective triple blind study performed in 40 consecutive patients with squamous cell carcinoma of the oral cavity.


METHODS
40 consecutive patients suffering primary oral squamous cell carcinoma, without any treatment before surgery, palpation or CT Scan.


RESULTS
40% of the cases showed metastasis in pathological study. Sensitivity was 100%, 94% and 75% for MGSS 13, CT scan and palpation, respectively. Specificity was 83%, 38% and 25-50% for palpation, CT scan and MGSS 13-17, respectively. Negative predictive result values were 100%, 90% and 83% for MGSS 13, CT Scan and palpation. The logistic regression analysis showed an independent predictor factor for palpation (p=0.001) and MGSS (p=0.01). The combination of MGSS and clinical palpation allowed a new design for evaluating neck metastasis in oral cancer. This method establishes 3 different groups at risk: 3 of very low (<2%), 2 of low risk (18-27%) and 1 of high risk (85%).


CONCLUSIONS
MGSS predicts metastasis better than CT scan and palpation. Combination of MGSS and palpation improves the prediction of metastasis.
Oral and Maxillofacial Surgery Department, Hospital Universitario de Canarias, Carretera La Cuesta-Taco s/n, La Laguna, Santa Cruz de Tenerife, Spain. ortomaxi@yahoo.es
Carlos
C
Martínez-Gimeno
Luisa Elena
LE
Rodríguez-Delgado
Antonio
A
Perera-Molinero
María del Carmen
Mdel C
Trujillo
Ana
A
Chivite
Maria Carmen
MC
Maeso
Armando
A
Aguirre-Jaime
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016015:Logistic Models; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D009333:Neck; D037981:Neck Dissection / Q000706:statistics & numerical data; D060787:Neoplasm Grading / Q000379:methods; D010173:Palpation; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed