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CT-scan prediction of thyroid cartilage invasion for early laryngeal squamous cell carcinoma

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Abstract

Treatment choice for laryngeal cancer may be influenced by the diagnosis of thyroid cartilage invasion on preoperative computed tomography (CT). Our objective was to determine the predictive value of CT for thyroid cartilage invasion in early- to mid-stage laryngeal cancer. Retrospective study (1992–2008) of laryngeal squamous cell carcinoma treated with open partial laryngectomy and resection of at least part of the thyroid cartilage. Previous laser surgery, radiation therapy, chemotherapy and second primaries were excluded. CT prediction of thyroid cartilage invasion was determined by specialized radiologists. Tumor characteristics and pathologic thyroid cartilage invasion were compared to the radiologic assessment. 236 patients were treated by vertical (20 %), supracricoid (67 %) or supraglottic partial laryngectomy (13 %) for tumors staged cT1 (26 %), cT2 (55 %), and cT3 (19 %). The thyroid cartilage was invaded on pathology in 19 cases (8 %). CT’s sensitivity was 10.5 %, specificity 94 %, positive predictive value 13 %, and negative predictive value 92 %. CT correctly predicted thyroid cartilage invasion in only two cases for an overall accuracy of 87 %. Among the false-positive CT’s, tumors involving the anterior commissure were significantly over-represented (61.5 % vs. 27 %, p = .004). Tumors with decreased vocal fold (VF) mobility were significantly over-represented in the group of false-negatives (41 vs. 13 %, p = .0035). Preoperative CT was not effective in predicting thyroid cartilage invasion in these early- to mid-stage lesions, overestimating cartilage invasion for AC lesions and underestimating invasion for lesions with decreased VF mobility.

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Authors and Affiliations

  1. Department of Head and Neck Oncology, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France

    Dana M. Hartl, Morbize Julieron, Gérard Mamelle & François Janot

  2. Voice, Biomaterials and Head and Neck Oncology Research Laboratory, Department of Otolaryngology Head and Neck Surgery, CNRS UMR 7018, European Hospital Georges Pompidou, University Paris Descartes, AP-HP, 20 rue Leblanc, 75908, Paris Cedex 15, France

    Guillaume Landry, Stéphane Hans & Daniel F. Brasnu

  3. Department of Radiology, Institut Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France

    François Bidault

Authors
  1. Dana M. Hartl
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  2. Guillaume Landry
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  3. François Bidault
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  4. Stéphane Hans
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  5. Morbize Julieron
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  6. Gérard Mamelle
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  7. François Janot
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  8. Daniel F. Brasnu
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Corresponding author

Correspondence to Dana M. Hartl.

Additional information

Abstract accepted for oral presentation at the American Laryngological Association spring meeting, April 27, 2011.

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Hartl, D.M., Landry, G., Bidault, F. et al. CT-scan prediction of thyroid cartilage invasion for early laryngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 270, 287–291 (2013). https://doi.org/10.1007/s00405-012-2005-8

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  • DOI: https://doi.org/10.1007/s00405-012-2005-8

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