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September 1987

Metastatic Neck Disease: A Clinical, Roentgenographic, and Pathologic Correlative Study

Author Affiliations

Columbus, Ohio

Arch Otolaryngol Head Neck Surg. 1987;113(9):921. doi:10.1001/archotol.1987.01860090019013

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The presentation by Jerome L. Freeman, MD (Toronto), and coworkers at the April 29, 1987 meeting of the American Society for Head and Neck Surgery discussed a retrospective study intending to evaluate the role of computed tomography (CT) in staging the neck in patients with head and neck cancer. Their study involved an analysis of 75 patients from 1983 to 1987 whose neck nodal status was staged with CT scans prior to surgical nodal dissection. The roentgenographic staging was subsequently compared with clinical and histopathologic findings. Lymph nodes that were missed by the examining physician were also recorded as a separate subgroup. This study demonstrated that CT scanning always detected the palpable metastatic nodes, but that it detected only 10% of occult malignant nodes. In other words, 90% of occult positive metastatic nodes were missed by CT criteria. The authors also noted that

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