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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2023; 27(04): e571-e578
DOI: 10.1055/s-0042-1758208
Original Research

Comparison of Clinical and Pathological Staging in Patients with Head and Neck Cancer After Neck Dissection

João Viana Pinto 
1   Otorhinolaryngology Department, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
2   Otorhinolaryngology, Surgery and Physiology Department, Faculdade de Medicina do Porto, Universidade do Porto, Porto, Portugal
3   Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS), Porto University, Portugal
,
Mafalda Martins Sousa 
1   Otorhinolaryngology Department, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
2   Otorhinolaryngology, Surgery and Physiology Department, Faculdade de Medicina do Porto, Universidade do Porto, Porto, Portugal
,
Helena Silveira 
1   Otorhinolaryngology Department, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
2   Otorhinolaryngology, Surgery and Physiology Department, Faculdade de Medicina do Porto, Universidade do Porto, Porto, Portugal
,
Fernando Vales 
1   Otorhinolaryngology Department, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
2   Otorhinolaryngology, Surgery and Physiology Department, Faculdade de Medicina do Porto, Universidade do Porto, Porto, Portugal
,
Carla Pinto Moura 
1   Otorhinolaryngology Department, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
4   Department of Medical Genetics, Centro Hospitalar Universitário S. João, Faculdade de Medicina do Porto, Universidade do Porto, Porto, Portugal
5   Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal
› Author Affiliations Funding The author(s) received no financial support for the research.
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Abstract

Introduction Clinical and pathological staging plays an important role on the prognosis of head and neck cancer (HNC) patients.

Objective The present study aims to compare clinical and pathological T, N and overall staging in patients with HNC, to identify factors associated with these discrepancies, and to analyze and compare survival or disease-free survival in staging disagreements.

Methods Retrospective cohort including every patient submitted to neck dissection from January 2010 to December 2020 in the department of Otorhinolaryngology of a tertiary hospital center.

Results A total of 79 patients were analyzed; their mean age was 58.52 ± 13.15 years old and 88.9% were male. Assessing overall staging, discrepancies were noted in 53% (36.4% upstaging and 16.6% downstaging) and were significantly associated with clinical overall staging (p = 0.006). Regarding T staging, differences were noted in 45.5% (30.3% upstaging and 15.2% downstaging) and were significantly associated with imaging modality (p = 0.016), clinical T staging (p = 0.049), and histology (p = 0.017). Discrepancies in N staging were noted in 38% (25.3% upstaging and 12.7% downstaging) and were significantly associated with age (p = 0.013), clinical N staging (p < 0.001), and presence of extranodal invasion (p < 0.001). Both in Overall, T, and N staging, the aforementioned disagreements were not associated with either higher mortality or higher disease relapse.

Conclusion Overall, T, and N staging disagree in an important number of cases, and the overall stage can disagree in up to 53% of the cases. These disagreements do not seem to influence overall and disease-free survival.

Keywords

head and neck cancer - neck dissection - squamous cell carcinoma of head and neck


Publication History

Received: 14 November 2021

Accepted: 30 June 2022

Article published online:
14 September 2023

© 2023. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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