Background: There is no previously published information on clinicians' abilities to accurately differentiate between different stages of node positive disease in head and neck cancer.
Methods: Forty-two surgeons examined standardized nodes in a model neck and estimated nodal size. Each recorded their confidence in their ability to perform the task using a visual analogue scale. Reference nodes of known size were provided for comparison during a second examination of each node. The study was repeated after 1 month.
Results: Accuracy was poor and was not dependent on experience or confidence. There was a tendency to underestimate the size of smaller nodes. Estimates were strongly influenced by volume independent of largest diameter (p <.001). Reference nodes aided accuracy (p =.031). Subjects were not consistent on repeated testing (p <.001).
Conclusions: Both trainees and specialists are poor at accurately staging nodal disease using palpation alone.
Copyright 2001 John Wiley & Sons, Inc.