BACKGROUND: @entity189 of the upper aerodigestive tract are characterized by a high incidence of local @entity3 in the neck. The presence of lymph node @entity3 represents the most unfavorable prognostic factor for these @entity5 . A diagnostic routine is needed in order to identify the highest number of neck @entity3 , thereby optimizing the selection of @entity1 eligible for surgical neck treatment and reduce costs and length of hospital stay. MATERIALS AND METHODS: Our study analyzes the sensibility, specificity, and diagnostic accuracy of clinical examination, echography (US), computed tomography (CT) in cervical @entity3 detection by comparing them with the histopathological examination of the neck dissection specimens (pN) in 53 @entity1 suffering from @entity189 of the upper aerodigestive tract. RESULTS: Clinical examination: sensibility 82.1%; specificity 80%; diagnostic accuracy 81.1%; US with a cut off point for minimal adenopathy diameter of 0.5 cm 92.8% sensibility, 60% specificity, 77.3% diagnostic accuracy; US with cut off point 1 cm 82.1% sensibility, 80% specificity, 81.1% diagnostic accuracy; US with cut off point 1 cm, also considering round shape or multiplicity of the adenopathy: 82.1 sensibility, 80% specificity, 81.1% diagnostic accuracy; CT with cut off point 0.5 cm: 92.8% sensibility, 32% specificity, 64.1% diagnostic accuracy; CT with cut off point 1 cm: 85.7% sensibility, 64% specificity, 75.4% diagnostic accuracy; CT with cut off point 1 cm, also considering central @entity39 , extracapsular spread, multiplicity of the adenopathy 89.2 sensibility, 60% specificity, 75.5% diagnostic accuracy. CONCLUSIONS: By relating the results obtained from preoperative methods to the anatomopathological analysis of the surgical specimens we can draw the following conclusions: a) a neck positive to palpation in a subject with @entity189 of the upper aero digestive tract must be submitted to neck dissection. Such @entity1 have an 81.1% likelihood of having a @entity3 . In these @entity1 the use of radiologic studies of the neck must be restricted to cases with uncertain involvement of retropharingeal, mediastinic, paratracheal lymph nodes or in the follow-up after treatment; b) a neck negative to palpation in a subject with @entity189 of the upper aero digestive tract, must be further investigated. The US and the CT must use a cut-off point of 1 cm to consider a neck positive. Radiologic criteria for @entity5 , i.e., multiplicity, roundish shape, central @entity39 and capsular invasion do not significantly increase the diagnostic accuracy of the radiographic methods; c) the combined use of US and CT does not offer significant advantages in the detection of @entity3 , in any case CT is preferable when @entity5 has to be evaluated; d) the assessment of @entity1 that are negative to palpation and to US and to CT must consider the parameters linked with @entity5 , such as site and size, Broder's grading, Invasive Cell Grading, and thickness.

Pre-operative evaluation of cervical XXXX of the upper aerodigestive tract.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity39 :: ('MESH:D009336', 'Disease') :: ['necrosis'] @entity5 :: ('MESH:D009369', 'Disease') :: ['primary tumor', 'malignancy', 'tumors'] @entity189 :: ('MESH:D002277', 'Disease') :: ['Carcinomas', 'carcinoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis']
@entity5 :: (MESH:D009369,Disease) :: ['adenopathies in tumours']
