Ultrasound-guided fine-needle aspiration cytology followed by neck dissection after chemoradiotherapy

Abstract

A combination of concurrent chemoradiotherapy in the treatment of advanced-staged head and neck cancer has improved loco-regional control and increased complete clinical and pathologic response rates in the neck. However, for those patients with residual neck disease on a post-treatment computed tomography (CT) scan or ultrasonography, there remains significant controversy as to how to further assess the neck for the presence of viable tumor cells. In this study, we investigated the accuracy of ultrasound-guided fine-needle aspiration cytology after chemoradiotherapy.
Twenty-three patients with suspicion of residual neck disease who initially received chemoradiotherapy underwent ultrasound-guided fine-needle aspiration cytology prior to salvage neck dissection. Neck dissection specimens contained viable tumors in 10 (43.5%) patients. Ultrasound-guided fine-needle aspiration cytology had a sensitivity of 60.0% and specificity of 83.3% when an inadequate specimen was included in negative results.
We conclude that ultrasound-guided fine-needle aspiration has some worth in evaluating whether or not residual neck disease is viable.