Role of chest CT in staging of oropharyngeal cancer: a systematic review.

McLeod, Niall M H; Jess, Alex; Anand, Rajiv; Tilley, Elisabeth; Higgins, Bernie; Brennan, Peter A · Head Neck · 2009

systematic_review · Level I

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Abstract

The prevalence of synchronous or metastatic tumors in patients with head and neck squamous cell carcinoma (HNSCC) ranges from 6% to 20% and has implications for prognosis and management of the primary disease. There is no consensus about the role of chest CT prior to definitive treatment patients with HNSCC. A systematic review of all chest CT studies in relation to HNSCC was performed, together with a review of our local database. Twenty-four studies were identified in addition to our local data. Prevalence of positive chest CT was 7.93%. Patients were significantly more likely to have a positive chest CT with N2 or N3 neck disease (p = .0062) and stage III or IV disease (p = .0001), and significantly less likely with tumors of the oral cavity (p = .0007). We advocate chest CT as part of the initial investigations for patients with HNSCC.

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