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Neck Cancer

Surgery Detection of lymph node metastasis. January 28, 2006. STATEMENTS ON. Head and. Neck Cancer. Frankfurt am Main, Germany. Surgery Detection of lymph node metastasis. Moderator Petra Ambrosch Speaker Thomas Vogl Panelists György Lichtenberger Patrick Bradley Rene Leemans.

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Neck Cancer

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  1. SurgeryDetection of lymph node metastasis January 28, 2006 STATEMENTS ON Head and Neck Cancer Frankfurt am Main, Germany

  2. SurgeryDetection of lymph node metastasis Moderator Petra Ambrosch Speaker Thomas Vogl Panelists György Lichtenberger Patrick Bradley Rene Leemans

  3. Histopathological methods represent the “gold standard” detecting lymph node metastases requiring open surgery To avoid open surgery, imaging techniques are sought to depict metastasis

  4. Author Modality Sensitivity Specificity N Righi et al. CT 60% 100% 25 (1997) US-FNAC 50% 100% 25 vd Brekel et al. CT 49% 78% 86 (2002) MRI 55% 88% 83 US 58% 57% 88 US-FNAC 73% 100% 43 Popperl et al. CT/MRI 74% 57% 115 (2002) PET 71% 86% 115 Dresel et al. CT 74% 76% 90 (2003) MRI 75% 100% 18 PET 82% 96% 111 US 91% 81% 100

  5. Depicting lymph node metastasis PET seems to be superior to CT/MRI but inferior to US/US-FNAC Accuracy of imaging procedures also depend on the observer

  6. US, MRI, CT, PET Canimaging proceduresreplaceinvasive detection techniques ? Elective (selective) neck dissection, sentinel lymph node biopsy

  7. ...Imaging procedures help select necks that do not need treatment, thus minimize morbidity of the patients by prevention of overtreatment   

  8. What are indications for sentinel lymph node biopsy or elective selective neck dissection in case of N0 neck according to imaging ?

  9. Risk of metastasizing • Site • T category • Depth of invasion • Tumor volume • Histopathological grade • Vessel invasion • Perineural spread

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