Rb. Prehn et al., Influence of computed tomography on pretherapeutic tumor staging in head and neck cancer patients, OTO H N SUR, 119(6), 1998, pp. 628-633
Refinements in radiographic techniques have resulted in increased use of ra
diographic studies in the evaluation of patients with head and neck cancer
over the past 20 years. To assess the impact of such studies, we compared t
umor clinical stages based solely on physical-examination findings with tho
se obtained with the addition of CT findings. This study was accomplished t
hrough case review of 81 head and neck cancer patients who underwent CT aft
er preliminary TNM-stage assignment as determined on the basis of physical
examination alone. In this cohort, 44 patients (54%) had a change in assign
ed clinical stage. We reviewed individual anatomic sites to determine where
CT was found to be most useful in modifying tumor stage. Changes in tumor
and nodal stage were found across all major sites of the head and neck. Tum
ors of the hypopharynx were the most likely to change stage (90%) on the ba
sis of CT findings, whereas tumors of the glottic larynx were least likely
to undergo a change in stage (16%), The therapeutic implications of these f
indings are discussed in the context of the published literature.