Contrast-enhanced CT for the diagnosis of extracapsular spread by head and neck cancers: a systematic review and meta analysis

doi:10.19439/j.sjos.2018.06.023

Abstract

Abstract: PURPOSE: This study aimed to assess the diagnostic efficacy of contrast-enhanced CT in the screening of extracapsular spread by head and neck cancers. METHODS: Electronic databases, including MEDLINE, EMBASE,CBM,CNKI and SciencePaper Online were searched electronically. Hand-searching was also performed. QUADAS-2 was used by two independent reviewers to assess the methodological quality, and data extraction of included studies was delivered. Meta analysis was conducted via MetaDisc1.4 and STATA 11.0. RESULTS: A total of 8 studies involving 639 participants were included. All studies were retrospective, 1 had high risk of bias, and the remaining had unclear risk of bias. Meta analysis showed that when screening extracapsular spread, contrast-enhanced CT had a pooled sensitivity of 0.67, pooled specificity of 0.84, area under curve of 0.83. CONCLUSIONS: Contrast-enhanced CT is a good tool for diagnosing extracapsular spread by head and neck cancers.

Key words: Head and neck cancers, Lymphatic metastasis, Extracapsular spread, Systematic review, Diagnostic test, Meta analysis

CLC Number:

R739.8

TANG Cao-min, QIAO Xiang-he, LI Chun-jie, YAN Kai-xiao, LIN Jie, WANG Xiao-yi. Contrast-enhanced CT for the diagnosis of extracapsular spread by head and neck cancers: a systematic review and meta analysis[J]. Shanghai Journal of Stomatology, 2018, 27(6): 668-672.

References

[1] Wang W, Lim WK, Leong HS, et al.An eleven gene molecular signature for extra-capsular spread in oral squamous cell carcinoma serves as a prognosticator of outcome in patients without nodal metastases[J]. Oral Oncol, 2015, 51(4): 355-362.
[2] Clark J, Li W, Smith G, et al.Outcome of treatment for advanced cervical metastatic squamous cell carcinoma[J]. Head Neck, 2005, 27(2): 87-94.
[3] Whiting PF, Rutjes AW, Westwood ME, et al.QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies[J]. Ann Intern Med, 2011, 155(8): 529-536.
[4] Li C, Yang W, Men Y, et al.Magnetic resonance imaging for diagnosis of mandibular involvement from head and neck cancers: a systematic review and meta-analysis[J]. PloS One, 2014, 9(11): e112267.
[5] Zamora J, Abraira V, Muriel A, et al.Meta-DiSc: a software for meta-analysis of test accuracy data[J]. BMC Med Res Methodol, 2006, 6: 31.
[6] Carvalho P, Baldwin D, Carter R, et al.Accuracy of CT in detecting squamous carcinoma metastases in cervical lymph nodes[J]. Clin Radiol, 1991, 44(2): 79-81.
[7] King AD, Gary MK, Yuen EHY, et al.Comparison of CT and MR imaging for the detection of extranodal neoplastic spread in metastatic neck nodes[J]. Eur J Radiol, 2004, 52(3): 264-270.
[8] 罗德红,石木兰,徐震纲, 等. 颈部转移淋巴结的CT、B超检查与病理对照研究(Ⅱ.包膜外侵犯的诊断)[J]. 中华放射学杂志, 1997, 31(11): 758-761.
[9] Souter MA, Allison RS, Clarkson JH, et al.Sensitivity and specificity of computed tomography for detection of extranodal spread from metastatic head and neck squamous cell carcinoma[J]. J Laryngol Otol, 2009, 123(7): 778-782.
[10] Steinkamp HJ, van der Hoeck E, Böck JC, et al. The extracapsular spread of cervical lymph node metastases: the diagnostic value of computed tomography[J]. Rofo, 1999, 170(5): 457-462.
[11] Chai RL, Rath TJ, Johnson JT, et al.Accuracy of computed tomography in the prediction of extracapsular spread of lymph node metastases in squamous cell carcinoma of the head and neck[J]. JAMA Otolaryngol Head Neck Surg, 2013, 139(11): 1187-1194.
[12] Url C, Schartinger VH, Riechelmann H, et al.Radiological detection of extracapsular spread in head and neck squamous cell carcinoma (HNSCC) cervical metastases[J]. Eur J Radiol, 2013, 82(10): 1783-1787.
[13] Carlton JA, Maxwell AW, Bauer LB, et al.Computed tomography detection of extracapsular spread of squamous cell carcinoma of the head and neck in metastatic cervical lymph nodes[J]. Neuroradiol J, 2017, 30(3): 222-229.
[14] Puri SK, Fan CY, Hanna E.Significance of extracapsular lymph node metastases in patients with head and neck squamous cell carcinoma[J]. Curr Opin Otolaryngol Head Neck Surg, 2003, 11(2): 119-123.
[15] de Juan J, García J, López M, et al. Inclusion of extracapsular spread in the pTNM classification system: a proposal for patients with head and neck carcinoma[J]. JAMA Otolaryngol Head Neck Surg, 2013, 139(5): 483-488.
[16] Su Z, Duan Z, Pan W, et al.Predicting extracapsular spread of head and neck cancers using different imaging techniques: a systematic review and meta-analysis[J]. Int J Oral Maxillofac Surg, 2016, 45(4): 413-421.