Abstract
Objectives: N-Staging in head and neck cancer is necessary for indication in treatment of primary and recurrent tumors. Modern staging procedures allow increasingly reliable assessment of N-stage. This study evaluates the efficacy of the use of a single diagnostic method and the combination of various procedures (multimodal) with respect to diagnostic accuracy and cost-effectiveness.
Methods: 52 patients with malignant head and neck tumors underwent palpation, color duplex sonography (CDS), computed tomography (CT), and 18-FDG-positron emission tomography (PET) to assess N-stage. The histopathological findings were used as golden standard. Statistical analysis by means of multiple diagnostic tests was performed.
Results: Various combinations of imaging procedures result in diagnostic accuracies between 90.4% and 93.3%. The combination of color duplex sonography and palpation yielded 91.3%. The combined use of 18-FDG-PET and echography yielded the highest accuracy (93.3%) but failed to demonstrate statistical significance.
Conclusion: In head and neck cancer the combination of palpation and color duplex sonography is sufficient for N-staging. Applying more procedures will not significantly improve diagnostic accuracy. With respect to the restricted accessibility of ultrasound to some anatomical regions, this method can be recommended for cervical N-staging. These results can contribute to cost-effectiveness in oncologic diagnosis.