TUMOR THICKNESS AS A MARKER OF CERVICAL NODAL METASTASIS IN PATIENTS WITH BUCCAL MUCOSA CARCINOMA

Abstract

Objective: To determine optimal cut-off value of tumor mucosal thickness predicting cervical lymph node metastasis in buccal mucosa carcinoma

Study Design: Prospective cross-sectional diagnostic accuracy study 

Place and Duration of Study: Otolaryngology department of Combined Military Hospital, Rawalpindi, Pakistan from June 2024 to May 2025

Methodology: A total of 90 patients were analyzed in the study planned for elective buccal mucosa tumor and cervical nodal dissection. Primary variable studied was suitable cut-off for tumor thickness in predicting cervical nodal metastasis and sensitivity, specificity, positive and negative predictive value of tumor thickness cut-off in detection of cervical node metastasis

Results: Receiver operating characteristic (ROC) analysis identified 2.81 mm as the most suitable cut-off value for predicting cervical nodal metastasis, yielding a high Youden Index (J=0.817) with the cut-off corresponding to a sensitivity of 93.3%, specificity of 88.3%, positive predictive value of 80.0%, and negative predictive value of 96.4%. The overall diagnostic accuracy of tumor thickness at this cut-off was 90.0%

Conclusion: Tumor thickness demonstrated strong diagnostic accuracy for predicting cervical nodal metastasis in buccal mucosa squamous cell carcinoma, with a cut-off value of 2.8 mm providing excellent sensitivity and specificity.