ArticleCancers2026
Exploratory Analysis of Quantitative CT Metrics for Predicting Tumor Aggressiveness and Nodal Metastasis in Head and Neck Squamous Cell Carcinoma: A Retrospective Cohort Study.
Article in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPreoperative assessment of Head and Neck Squamous Cell Carcinoma (HNSCC) aggressiveness is often hindered by the sampling errors of incisional biopsies. While Contrast-Enhanced Computed Tomography (CECT) is the standard for staging, its potential to serve as a non-invasive complementary radiological tool of the entire tumor volume remains underutilized.
objectiveTo evaluate the predictive performance of preoperative CECT-derived tumor volume, densitometric values, and morphological features as predictors of histopathological grade and lymph node metastasis (pN) in HNSCC. The primary outcome was predicting lymph node metastasis (pN+), and the secondary outcome was predicting histopathological grade.
methodsThis retrospective observational study analyzed 42 patients with SCC of the oral cavity, larynx, or maxilla. Quantitative (3D volume, Hounsfield Units [HU], HU Delta) and qualitative (margins, lobulations, necrosis) CT parameters were correlated with definitive histopathology. Diagnostic performance was assessed using Receiver Operating Characteristic (ROC) curve analysis and Spearman's rank correlation.
resultsHigh-grade tumors (G2/G3) demonstrated significantly larger median volumes (18.1 vs. 2.9 cm
conclusionsPreoperative CECT parameters show promise as non-invasive imaging surrogates of HNSCC aggressiveness. A paradoxical reduction in contrast enhancement characterizes high-grade biology, reflecting disorganized neo-angiogenesis and internal hypoxia. Integrating 3D volumetric analysis and morphological markers shows potential as a complementary exploratory tool that, pending future prospective validation, may support risk stratification and surgical planning alongside traditional histopathological assessment.
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