A new method for the prediction of cervical node metastases in squamous cell carcinoma of the oral cavity: a combination of Martínez-Gimeno Scoring System and clinical palpation

Abstract

Aims: Evaluation of the accuracy of palpation, CT scan and Martínez-Gimeno Score System in the assessment of neck nodes metastasis in squamous cell carcinoma of the oral cavity.

Design: This is a prospective triple blind study performed in 40 consecutive patients with squamous cell carcinoma of the oral cavity.

Patients: 40 consecutive patients suffering primary oral squamous cell carcinoma, without any treatment before surgery, palpation or CT Scan.

Results: 40% of the cases showed metastasis in pathological study. Sensitivity was 100%, 94% and 75% for MGSS 13, CT scan and palpation, respectively. Specificity was 83%, 38% and 25-50% for palpation, CT scan and MGSS 13-17, respectively. Negative predictive result values were 100%, 90% and 83% for MGSS 13, CT Scan and palpation. The logistic regression analysis showed an independent predictor factor for palpation (p=0.001) and MGSS (p=0.01). The combination of MGSS and clinical palpation allowed a new design for evaluating neck metastasis in oral cancer. This method establishes 3 different groups at risk: 3 of very low (<2%), 2 of low risk (18-27%) and 1 of high risk (85%).

Conclusions: MGSS predicts metastasis better than CT scan and palpation. Combination of MGSS and palpation improves the prediction of metastasis.