Risk Scoring System Validity for Detection of Cervical Nodal Metastasis in patients with Head and Neck Squamous Cell Carcinoma

Abstract

Background: The presence of lymph node metastasis has a great impact on treatment and prognosis in patients with head and neck Squamous Cell Carcinoma. This study targeted to detect cervical node metastasis by using An accurate MDCT scoring system in patients with HNSCCC. Patients and Methods: A cross sectional study in Zagazig University Hospital during the period from November  2019 to April 2020. Included 76 lymph nodes from thirty patients with HNSCC. We analyzed preoperative CT images of lymph nodes including diameter, ratio of long to short axis diameter, necrosis and T stage of the primary tumor. The reference standard comprised pathologic results. Multivariable logistic regression analysis was performed to evaluate the risk scoring system. Results: A risk scoring system (shortest axial diameter, L/S ratio, necrosis and T stage) showing risk of malignancy ranged from 7.3% to 99.8%, which was positively associated with increased scores. Area under curve of the risk scoring system were 0.886 with a 95%CI, 0.881-0.920.The optimism corrected performance was good (AUC=0.879, 94%CI=0.914) the hosmer-lemeshow goodness of fit test indicated the prediction model and scoring system were well calibrated (P.160).the caliberation plot showed good agreement between the predicited and actual risks of lymph node metastasis. Conclusion: A risk scoring system using CT characteristic of lymph nodes and tumors for HNSCC could be feasible to stratify the risk of cervical lymph node metastasis with high diagnostic accuracy.