Ultrasound-guided aspiration cytology for the assessment of the clinically N0 neck: factors influencing its accuracy.

Background: Ultrasound-guided fine-needle aspiration cytology (US-FNAC) can be used to diminish the risk of missing occult metastases and for early detection during follow-up.

Methods: A retrospective study was performed in 163 surgically treated patients without palpable neck nodes (N0). One hundred twenty-six patients underwent planned elective neck dissections, and 37 were planned for a wait-and-see strategy, but preoperative US-FNAC could change this policy if metastases were detected.

Results: In the elective neck dissection group, US-FNAC had a sensitivity of 39%, whereas in the wait-and-see group, the sensitivity was 18%. The 5-year survival in the wait-and-see group did not differ from the patients with early oral cancer who underwent an elective neck dissection.

Conclusions: Although the sensitivity of US-FNAC in this study is low, especially in small oral cancer, the prognosis in the wait-and-see group is not affected. However, a wait-and-see strategy is only advantageous to a minority of the patients.