Discrepancy Between cTNM and pTNM in Patients with Oral Squamous Cell Carcinoma

Ramish Tariq, S. Qureshi, Muhammad Khalid, O. Janjua, K. Zafar, Malik Muhammad Usama
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Abstract

Objective: To analyze discrepancy between cTNM and pTNM in patients with squamous cell carcinoma of oral cavity. Study design: Cross-sectional study. Setting & Duration: Cases of OSCC treated in Oral and Maxillofacial Surgery Department, Allied Hospital Faisalabad from December 2017 to November 2020 were included in the study. Methodology: Total 80 patients with biopsy proven OSCC were enrolled in the study. cTNM staging was based on clinical examination and CT/MRI. Primary tumor excision along with neck dissection was done in all patients. Postoperatively pTNM staging was done and compared to cTNM. The clinical, radiological and histopathological lymph node status of patients were compared. Results: Among 80 patients, male to female ratio was 1.6:1. The mean of age was 50.2±10.2 years. The most common site in our center was the lateral border of the tongue. The total coincidence rate between clinical T-stage and pathological T-stage was 57.5%. On comparison between the clinical and pathological N-stage the total coincidence rate was 40%. The total coincidence rate between cTNM and pTNM was 35% and the p-value was insignificant (p>0.05). The sensitivity of CT/MRI for N-stage was 53.3% and specificity was 60% and positive predictive value (PPV) was 53.3% and negative predictive value (NPV) was 60%. Conclusion: Disparity between cTNM and pTNM of OSCC exits that could affect the treatment planning and prognosis.
cTNM与pTNM在口腔鳞状细胞癌中的差异
目的:分析口腔鳞状细胞癌患者cTNM与pTNM的差异。研究设计:横断面研究。环境和持续时间:纳入2017年12月至2020年11月在费萨拉巴德联合医院口腔颌面外科治疗的OSCC病例。方法:共80例活检证实的OSCC患者被纳入研究。cTNM分期基于临床检查和CT/MRI。所有患者均行原发肿瘤切除及颈部清扫术。术后进行pTNM分期并与cTNM进行比较。比较患者的临床、影像学及组织病理学淋巴结状况。结果:80例患者中男女比例为1.6:1。平均年龄50.2±10.2岁。在我们的中心最常见的位置是舌的外侧边界。临床t分期与病理t分期的总符合率为57.5%。临床n期与病理n期比较,总符合率为40%。cTNM与pTNM的总符合率为35%,p值不显著(p < 0.05)。CT/MRI对n期的敏感性为53.3%,特异性为60%,阳性预测值(PPV)为53.3%,阴性预测值(NPV)为60%。结论:OSCC出口cTNM与pTNM的差异可能影响治疗方案和预后。
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