RADIOLOGIC-PATHOLOGIC CORRELATION OF EXTRANODAL EXTENSION IN PATIENTS WITH SQUAMOUS CELL CARCINOMA OF THE ORAL CAVITY

ABSTRACT

Background: The purpose of this study was to assess the accuracy of preoperative CT imaging for predicting pathologic nodal ECE (pECE). To estimate the accuracy of the presence of radiologic extranoda AIM: l extension (rENE) in reference to pathologic extranodal extension (pENE) in patients with oral cavity squamous cell carcinoma (OSCC) MATERIALS AND METHODS: This is a prospective study in GSVM Medical College, LLR & Associated Hospitals, Kanpur (UP). The records of 50 consecutive patients with oral cavity cancer (OCC) who underwent preoperative CT imaging before initial surgical resection and neck dissection between 2020 and 2021 were reviewed. Specimens with pECE had the extent of ECE graded on a scale from 1 to 4. Radiographic ECE was RESULTS: documented in 6 patients (12%), and pECE was observed in 11 (22%). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 45.4%, 97.4%, 83.6%, and 86.3%, respectively. The sensitivity of radio- graphic ECE increased from 40% for grade 1 to 2 ECE, to 50% for grade 3, and 50% for grade 4. Radiographic ECE criteria of adjacent structure invasion was a better predictor than irregular borders/fat stranding for pECE. Radiographic ECE has poor sensitivity, but excellent spec CONCLUSION:Radiographic ECE criteria ificity for pECE in patients who undergo initial surgical resection. PPV and NPV are reasonable for clinical decision making. The performance of preoperative CT imaging increased as pECE grade increased.