Radiological staging of the chest and abdomen in head and neck squamous cell carcinoma - are computed tomography and ultrasound necessary?

The need for, and choice of, radiological staging investigations for distan t metastases in the management of head and neck squamous cell carcinoma is a contentious issue. To address this problem a retrospective audit of routi ne computerized tomography (CT) and ultrasound scanning of the chest and ab domen respectively was undertaken. The records of 103 patients who, over a six and a half year period, underwent major surgery for head and neck squam ous cell carcinoma were reviewed. A total of 57 patients (59 per cent) had CT scanning of the chest of whom two were identified as having synchronous tumours. In both cases, the lesions were identified on chest X-ray prior to scanning. Seventy patients (68 per cent) had routine ultrasound scanning o f the abdomen. In none of these was metastatic disease identified. As a res ult of the audit findings routine CT and ultrasound scanning of the chest a nd abdomen has been discontinued.