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C-0770 - Staging head and neck cancer: which method should we use to measure nodal size? 

Q. AI, A. D. King, F. Mo, K. S. S. k. Bhatia, B. Ma, K. KAM, M. poon; Hong Kong/HK Type: Scientific Exhibit
Area of Interests: Lymph nodes, Oncology, Head and neck
Imaging Technique: MR
Procedure: Outcomes analysis
Special Focuses: Cancer, Outcomes
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Aims and objectives: The maximum dimension (MD) of single/confluent metastatic nodes in the neck is a surrogate of nodal volume (NV) for nodal staging of head and neck cancer. N3 disease, which is defined as a lymph node with largest dimension of > 6.0 cm (N3a) or metastasis spread to supraclavicular fossa (N3b), is [...]

Methods and materials: Pre-treatment head and neck MRI was performed in 712 patients with biopsy-proven NPC without evidence of distant metastases at diagnosis. The protocol consisted of a minimum of an axial fat-suppressed T2-weighted sequence; an axial T1- weighted spin-echo sequence, and an axial and coronal T1-weighte[...]

Results: Patients were followed-up with a median time of 83.0 months (range: 3.2 – 242.6 months). Patients’ demographics, the MDs, total NV, T and N stages, clinical stage groups, and treatment were shown in table 1. The 5-year OS and 5-year DSS were 74.4%, 79.4%. MDcontiguous has the strongest correlation w[...]

Conclusion: The maximum diameter of contiguous nodes, in the axial or coronal plane, was the best method measuring the size of NPC metastatic nodes for nodal staging. The MDcontiguous showed the highest correlation with total NV and was the only method of measurement that was an independent predictor of OS and [...]

Personal information: Qi-Yong Ai, M.B.B.S.; Ann D. King, F.R.C.R.; Kunwar S. Bhatia, F.R.C.R.; Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong S.A.R., China Frankie K.F. Mo, Ph.D.; Brigette B. Ma, F.R.A.C.P; Micheal K. M. Kam; Darren M.C. Poon; [...]

References: ADDIN Mendeley Bibliography CSL_BIBLIOGRAPHY 1. Li W-F, Sun Y, Mao Y-P, et al. Proposed lymph node staging system using the International Consensus Guidelines for lymph node levels is predictive for nasopharyngeal carcinoma patients from endemic areas treated with intensity modulated radiation thera[...]

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