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Med J Malaysia ; 79(2): 196-202, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38553926

ABSTRACT

OBJECTIVE: The standard treatment for regional failure in nasopharyngeal carcinoma (NPC) is the radical neck dissection (RND). Our study sought to determine if magnetic resonance imaging (MRI) may accurately predict nodal involvement to allow selected levels of neck dissection to be preserved. STUDY DESIGN AND SETTING: We analysed retrospectively all NPC patients in our centre undergoing neck dissections as salvage therapy for nodal recurrence. Nodal involvement based on the preoperative MRI was assessed and compared with postoperative histopathology. METHODS: This is a retrospective study conducted on patients in our centre with recurrent NPC from February 2002 to February 2017. Patients were identified from the database of the otolaryngology oncology division at our institution. Of these, 28 patients met all our inclusion and exclusion criteria. We calculated sensitivity and specificity as well as average number of nodes per patient. RESULTS: In our study, we calculated the false negative and false positive rates of preoperative MRI neck by levels. Overall sensitivity of MRI picking up disease by level was 76% and specificity was 86%. CONCLUSION: Based on our study, we will be missing a total of 10 (7.1%) diseased neck levels in eight (28.5%) patients. MRI alone, therefore, does not provide enough information to allow safe selective preservation of neck levels in surgical salvage of neck recurrences in NPC.


Subject(s)
Nasopharyngeal Neoplasms , Neck Dissection , Humans , Neck Dissection/methods , Nasopharyngeal Carcinoma/surgery , Retrospective Studies , Nasopharyngeal Neoplasms/diagnostic imaging , Nasopharyngeal Neoplasms/surgery , Nasopharyngeal Neoplasms/pathology , Salvage Therapy , Neoplasm Recurrence, Local/surgery , Lymphatic Metastasis
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