Role of chest CT in staging of oropharyngeal cancer: a systematic review.

Background. The prevalence of synchronous or metastatic tumors in patients with head and neck squamous cell carcinoma (HNSCC) ranges from 6% to 20% and has implications for prognosis and management of the primary disease. There is no consensus about the role of chest CT prior to definitive treatment patients with HNSCC. Methods. A systematic review of all chest CT studies in relation to HNSCC was performed, together with a review of our local database. Results. Twenty-four studies were identified in addition to our local data. Prevalence of positive chest CT was 7.93%. Patients were significantly more likely to have a positive chest CT with N2 or N3 neck disease (p = .0062) and stage III or IV disease (p = .0001), and significantly less likely with tumors of the oral cavity (p = .0007). Conclusion. We advocate chest CT as part of the initial investigations for patients with HNSCC. © 2009 Wiley Periodicals, Inc. Head Neck, 2009