Advertisement

European Archives of Oto-Rhino-Laryngology

, Volume 270, Issue 1, pp 287–291 | Cite as

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

  • Dana M. HartlEmail author
  • Guillaume Landry
  • François Bidault
  • Stéphane Hans
  • Morbize Julieron
  • Gérard Mamelle
  • François Janot
  • Daniel F. Brasnu
Head and Neck

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.

Keywords

Larynx Cancer Computed tomography Thyroid cartilage 

Notes

Conflict of interest

None.

References

  1. 1.
    Sobin LH, Gospodarowicz M, Wittekind C (eds) (2010) UICC International Union Against Cancer. TNM classification of malignant tumors, 7th edn. Wiley-Blackwell, West SussexGoogle Scholar
  2. 2.
    Hartl DM, Landry G, Hans S, Marandas P, Brasnu D (2010) Organ preservation surgery for laryngeal squamous cell carcinoma: low incidence of thyroid cartilage invasion. Laryngoscope 120:1173–1176PubMedGoogle Scholar
  3. 3.
    Becker M (2000) Neoplastic invasion of laryngeal cartilage: radiologic diagnosis and therapeutic indications. Eur J Radiol 33:216–229PubMedCrossRefGoogle Scholar
  4. 4.
    Becker M, Zbären P, Delavelle J et al (1997) Neoplastic invasion of the laryngeal cartilage: reassessment of criteria for diagnosis at CT. Radiology 203:521–532PubMedGoogle Scholar
  5. 5.
    Li B, Bobinski M, Grandour-Edward R, Farwell DG, Chen AM (2011) Overstaging of cartilage invasion by multidetector CT scan for laryngeal cancer and its potential effect on the use of organ preservation with chemoradiation. Br J Radiol 84:64–69PubMedCrossRefGoogle Scholar
  6. 6.
    Daisne JF, Duprez T, Weynand B et al (2004) Tumor volume in pharyngolaryngeal squamous cell carcinoma: comparison at CT, MR imaging and FDG PET and validation with surgical specimen. Radiology 233:93–100PubMedCrossRefGoogle Scholar
  7. 7.
    Beitler JJ, Muller S, Grist WJ et al (2010) Prognostic accuracy of computed tomography findings for patients with laryngeal cancer undergoing laryngectomy. J Clin Oncol 28:2318–2322PubMedCrossRefGoogle Scholar
  8. 8.
    Thoeny HC, Delaere PR, Hermans R (2005) Correlation of local outcome after partial laryngectomy with cartilage abnormalities on CT. Am J Neuroradiol 26:674–678PubMedGoogle Scholar
  9. 9.
    Castelijns JA, Becker M, Hermans R (1996) Impact of cartilage invasion on treatment and prognosis of laryngeal cancer. Eur Radiol 6:156–169PubMedCrossRefGoogle Scholar
  10. 10.
    Tart RP, Mukherji SK, Lee WR, Mancuso AA (1994) Value of laryngeal cartilage sclerosis as a predictor of outcome in patients with stage T3 glottic cancer treated with radiation therapy. Radiology 192:567–570PubMedGoogle Scholar
  11. 11.
    Murakami R, Furusawa M, Baba Y et al (2000) Dynamic helical CT of T1 and T2 glottic carcinomas: predictive value for local control with radiotherapy. Am J Neuroradiol 21:1320–1326PubMedGoogle Scholar
  12. 12.
    Blitz AM, Aygun N (2008) Radiologic evaluation of larynx cancer. Otolaryngol Clin N Am 41:697–713CrossRefGoogle Scholar
  13. 13.
    Kurooka H, Kawabe J, Tsumoto C et al (2009) Examination of pattern of RI accumulation in thyroid cartilage on bone scintigraphy. Ann Nucl Med 23:43–48PubMedCrossRefGoogle Scholar
  14. 14.
    Kazkayasi M, Onder T, Ozkaptan Y, Can C, Pabuscu Y (1995) Comparison of preoperative computed tomographic findings with postoperative histopathological findings in laryngeal cancers. Eur Arch Otorhinolaryngol 252:325–331PubMedCrossRefGoogle Scholar
  15. 15.
    Bradley PJ, Rinaldo A, Suarez C et al (2006) Primary treatment of the anterior vocal commissure squamous carcinoma. Eur Arch Otorhinolaryngol 263:879–888PubMedCrossRefGoogle Scholar
  16. 16.
    Fernandes R, Gopalan P, Spyridakou C, Joseph G, Kumar M (2006) Predictive indicators for thyroid cartilage involvement in carcinoma of the larynx seen on spiral computed tomography scans. J Laryngol Otol 120:857–860PubMedCrossRefGoogle Scholar
  17. 17.
    Barbosa MM, Araujo JF Jr, Boasquevisque E et al (2005) Anterior vocal commissure invasion in laryngeal carcinoma diagnosis. Laryngoscope 115:724–730PubMedCrossRefGoogle Scholar
  18. 18.
    Kirchner JA (1998) Atlas on the surgical anatomy of laryngeal cancer. Singular Publishing Group Inc., San Diego, pp 36–60Google Scholar
  19. 19.
    Frata P, Cellai E, Magrini SM et al (2005) Radical radiotherapy for early glottic cancer: results in a series of 1087 patients from two Italian radiation oncology centers. II. The case of T2N0 disease. Int J Radiat Oncol Biol Phys 63:1387–1394PubMedCrossRefGoogle Scholar
  20. 20.
    Fein DA, Mendenhall WM, Parsons JT et al (1993) T1–T2 squamous cell carcinoma of the glottic larynx treated with radiotherapy: a multivariate analysis of variables potentially influencing local control. Int J Radiat Oncol Biol Phys 25:605–611PubMedCrossRefGoogle Scholar
  21. 21.
    Peretti G, Piassa C, Mensi MC, Magnoni L, Bolzoni A (2005) Endoscopic treatment of cT2 glottic carcinoma: prognostic impact of different pT subcategories. Ann Otol Rhinol Laryngol 114:579–586PubMedGoogle Scholar
  22. 22.
    Peretti G, Piazza C, Bolzoni A et al (2004) Analysis of recurrences in 322 Tis, T1 or T2 glottic carcinomas treated by carbon dioxide laser. Ann Otol Rhinol Laryngol 113:853–858PubMedGoogle Scholar
  23. 23.
    Connor S (2007) Laryngeal cancer: how does the radiologist help? Cancer Imaging 7:93–103PubMedCrossRefGoogle Scholar
  24. 24.
    Youssem DM, Gad K, Tufano RP (2006) Resectability issues with head and neck cancer. Am J Neuroradiol 27:2024–2036Google Scholar
  25. 25.
    Duflo S, Chrestian M, Guelfucci B, Chapsaur P, Moulin G, Zanaret M (2002) Comparaison dans les cancers du larynx entre l’imagerie par résonance magnétique et les coupes histologiques après laryngectomie. Ann Otolaryngol Chir Cervicofac 119:131–137PubMedGoogle Scholar
  26. 26.
    Katsounakis J, Remy H, Vuong T, Gélinas M, Tabah R (1995) Impact of magnetic resonance imaging and computed tomography on the staging of laryngeal cancer. Eur Arch Otorhinolaryngol 252:206–208PubMedCrossRefGoogle Scholar
  27. 27.
    Nishiyama Y, Yamamoto Y, Yokoe K et al (2004) Superimposed dual-isotope SPECT using 99mTc-hydroxymethylene diphosphonate and 201Tl-chloride to assess cartilage invasion in laryngopharyngeal cancer. Ann Nucl Med 18:527–532PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Dana M. Hartl
    • 1
    Email author
  • Guillaume Landry
    • 2
  • François Bidault
    • 3
  • Stéphane Hans
    • 2
  • Morbize Julieron
    • 1
  • Gérard Mamelle
    • 1
  • François Janot
    • 1
  • Daniel F. Brasnu
    • 2
  1. 1.Department of Head and Neck OncologyInstitut Gustave RoussyVillejuif CedexFrance
  2. 2.Voice, Biomaterials and Head and Neck Oncology Research Laboratory, Department of Otolaryngology Head and Neck Surgery, CNRS UMR 7018, European Hospital Georges PompidouUniversity Paris DescartesParis Cedex 15France
  3. 3.Department of RadiologyInstitut Gustave RoussyVillejuif CedexFrance

Personalised recommendations