Chung et al reported a score for predicting likelihood of cervical lymphadenopathy representing metastases in a patient with squamous cell carcinoma of the head and neck. The authors are from Chung-Ang University and University of Ulsan in Korea.
Patient selection: cervical lymphadenopathy and newly-diagnosed squamous cell carcinoma of the head and neck
Parameters:
(1) T-stage of tumor
(2) shortest axial diameter of lymph node in cm
(3) long to short axis ratio (L/S ratio)
(4) necrosis
Parameter
Finding
Points
T stage
T1 or T2
0
T3 or T4
1
shortest axial length
< 1 cm
0
1-1.99 cm
1
>= 2 cm
4
L/S ratio
< 1.5
1
>= 1.5
0
necrosis
no
0
yes
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
Total Score
Risk Group
Percent Metastases
0 or 1
low
<= 17%
2-4
intermediate
17-78%
5-9
high
>= 78%
Performance:
• The area under the ROC curve was 0.89 in derivation and 0.88 in validation cohorts.
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