Evaluation of the pretherapeutic staging in head-neck squamous cell carcinomas (HNSCC) – a retrospective study

To provide an individual therapy of head-neck squamous cell carcinomas (HNSCC), the staging is a crucial part of the oncological pathway. In a retrospective study, we compared the clinical tumour (cT) and lymph node (cN) status with the histopathological defined tumour (pT) and lymph node (pN) status in patients with HNSCC to evaluate the accuracy of the pretherapeutic staging. For 9 months, we evaluated the cT and cN status according to the 8^th edition of TNM classification of n = 44 patients with HNSCC of the oral cavity, pharynx and larynx, who were recommended for tumour resection and neck dissection. Preoperative staging was performed via panendoscopy, imaging with sonography, CT scan and MRI. We compared those to the postoperative pT and pN status. Statistical analysis was carried out via SPSS. The mean cT value was slightly higher than the mean pT value, while the mean cN value was lower than the mean pN value. There were positive correlations of the cT and pT values as well as for cN and pN values. Analysis showed a positive correlation of the cT value and the difference between cT and pT value and a negative correlation of the cN value and the difference between cN and pN value. Our data show a good correlation of the cT and the pT status as well as the cN and pN status. They also imply a tendency of overestimating the tumour’s extend and underestimating the infested lymph nodes. This might be explained by phenomena like e.g. peritumoural edema. The lower cN status is associated with a misjudgment of the pN status. This seems reasonable as small infiltrations of tumour cells do not change the macroscopic morphology of lymph nodes. The knowledge of the strengths and weaknesses of the preoperative staging should be considered in board recommendations.

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Publication History

Article published online:
10 June 2020