PATHOLOGICAL FINDINGS IN CLINICALLY FALSE-NEGATIVE AND FALSE-POSITIVENECK DISSECTIONS FOR ORAL-CARCINOMA

A series of 86 patients presenting with oral cancer underwent neck dis section (114 sides of neck), after preoperative staging by palpation u nder general anaesthesia and CT imaging. Detailed histopathological as sessment of the surgical neck dissection specimens showed the incidenc e of clinically false-negative and false-positive assessments was 27% and 40%, respectively. Extranodal spread of metastatic carcinoma was p resent in 16% of clinically negative necks. The pathological findings provided plausible explanations for the clinical misdiagnosis in all 1 9 of the false-positive necks and in 13 of the 18 false-negative necks , where micrometastases or metastasis to nodes measuring less than 1.7 cm accounted for five and seven misdiagnosed cases, respectively. We conclude that the most stringent clinical protocols, even when supplem ented by CT scanning, cannot be expected to achieve 100% accuracy. Det ailed histopathological assessment provides the most reliable, current ly available method of diagnosing cervical metastatic disease.