Current role of computed tomography imaging in the evaluation of cartilage invasion by laryngeal carcinoma

Pietragalla, Michele; Nardi, Cosimo; Bonasera, Luigi; Mungai, Francesco; Verrone, Giovanni Battista; Calistri, Linda; Taverna, Cecilia; Novelli, Luca; Locatello, Luca Giovanni; Mannelli, Giuditta; Gallo, Oreste; Miele, Vittorio

doi:10.1007/s11547-020-01213-y

Cited by 12 publications

(13 citation statements)

References 40 publications

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“…For some of these parameters, such as as true arytenoid fixation, even its ability to predict the pT classification alone is insufficient basing upon the computed kappa value. The role of head and neck exam with mirror and fiberoptic examination is prominent: in particular we believe it should be the only base for the assessment of laryngeal motility, which is eventually the main information for a safe recommendation of partial surgery as the probability of crico-arytenoid joint infiltration and of posterior paraglottic space invasion is proportional to the laryngeal motion impairment [ 40 , 41 ], and these are in turn the main factors impacting local failure in partial laryngeal surgery [ 17 , 32 ]. For other fundamental parameters, such as extensive cartilage invasion, the information comes exclusively from radiological evaluation.…”

Section: Discussionmentioning

confidence: 99%

Reliability of a Multidisciplinary Multiparametric Approach in the Surgical Planning of Laryngeal Squamous Cell Carcinomas: A Retrospective Observational Study

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Tramaloni

et al. 2022

JPM

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(1) Background: Endoscopy and morphological imaging are the mainstay of the diagnostic work up of laryngeal squamous cell carcinomas (LSCCs), which can be integrated in a multidisciplinary discussion to obtain a shared pretreatment staging. (2) Methods: A retrospective evaluation of patients, managed at a tertiary university hospital in Italy and submitted to major laryngeal surgery, has been performed. Four different stagings have been defined and compared: epTN (based on endoscopy and physical ENT examination); radTN (based on CT scan); cTN (based on multidisciplinary integration of the two above); pTN based on pathology on surgical samples. Oncological outcomes have been assessed. (3) Results: Three-year relapse free and disease specific survival were 88% and 92.5%, respectively, without significant differences between partial surgeries (n = 13) and total laryngectomies (n = 32). As for the pretreatment staging, and in particular the T classification, the cTN has been revealed as more reliable than epTN and radTN alone in predicting the final pT (Cohen kappa coefficient: 0.7 for cT, 0.44 for radT, 0.32 for epT). In the partial surgery group, we did not record any positive margin nor local recurrence, with a 100% overall and disease-specific survival. (4) Conclusions: The multidisciplinary approach is fundamental in the definition of the primary lesion in LSCC, in particular in order to safely perform surgical preservation of laryngeal function, which is associated with a higher laryngectomy-free survival than irradiation but to a lower salvageability in case of recurrence.

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Section: Discussionmentioning

confidence: 99%

Reliability of a Multidisciplinary Multiparametric Approach in the Surgical Planning of Laryngeal Squamous Cell Carcinomas: A Retrospective Observational Study

Rizzo

Crescio

Tramaloni

et al. 2022

JPM

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“…28 Contrast enhanced CT-scan is the most used imagine technique for staging and treatment planning, but has some limitations in the PGS, where the tumor can be hidden within the normal soft tissues, or in its capacity to diagnose with precision the presence of cartilage infiltration. 30,31 Pietragalla et al 32 evaluated the current role of computed tomography imaging in the evaluation of cartilage invasion by laryngeal carcinoma. CT images were corroborated with histologic evaluation after total laryngectomy.…”

Section: Discussionmentioning

confidence: 99%

Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments

et al. 2021

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Background: To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery. Methods: Two hundred and two consecutive pT3-T4a larynx carcinomas. Pre-epiglottic space involvement, anterior and posterior paraglottic space (PGS) involvement, vocal cord, and arytenoid mobility were determined. Local control with laser (LC), overall survival (OS), disease-specific survival (DSS), and laryngectomy-free survival (LFS) were evaluated. Results: The lowest LC was found in tumors with fixed arytenoid. In the multivariate analysis, positive margins (hazard ratio [HR] = 0.289 [0.085-0.979]) and anterior (HR = 0.278 [0.128-0.605]) and posterior (HR = 0.269 [0.115-0.630]) PGS invasion were independent factors of a reduced LC. Anterior (HR = 3.613 [1 .537-8.495]) and posterior ) PGS involvement were

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“…Although data about patients' perspectives of treatments remain still limited, it is well known that psychosocial distress caused by HNSCC diagnosis and treatment-related toxicities may lead patients to refusal or interruption of oncological care. In recent decades, some authors focused their effort on analyzing the subset of head and neck patients who are inclined to refuse treatment reporting that 1.3-1.7% of patients with HNSCC refused surgical-and/or radiotherapy-based definitive therapy [15][16][17][18][19][20][21][22][23][24][25][26].…”

Section: Preferences and Priorities Of Head And Neck Cancer Patientsmentioning

confidence: 99%

“…1 ). Contrast-enhanced (CE) computed tomography (CT) scan and/or magnetic resonance imaging (MRI) and positron emission tomography (PET) imaging were recommended as imaging workup [ 22 , 23 ] but the patient refused to perform any further diagnostic-therapeutic approach. Two months after the refusal, he presented with progressive disease (cT4aN2cM1, IVc stage) with CPS of 1 or more preferring a “chemo-free” approach with pembrolizumab monotherapy.…”

Section: Introductionmentioning

confidence: 99%

The impact of patient preference in the treatment algorithm for recurrent/metastatic head and neck squamous cell carcinoma

et al. 2022

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The advent of immune checkpoint inhibitors for recurrent/metastatic head and neck squamous cell carcinoma (RM-HNSCC) has revolutionized the standard of care approach in first-line treatment. The heterogeneity of disease presentation and treatment-related toxicities can be associated with suboptimal patient compliance to oncologic care. Hence, prioritizing quality of life and well-being are crucial aspects to be considered in tailoring the best treatment choice. The aim of our work is to present a short report on the topic of the patient’s preference in regard to treatment and its consequences on quality of life in the recurrent/metastatic setting. According to the literature, there’s an unmet need on how to assess patient attitude in respect to the choice of treatment. In view of the availability of different therapeutic strategies in first-line management of RM-HNSCC, increasing emphasis should be put on integrating patient preferences into the medical decision-making.

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Current role of computed tomography imaging in the evaluation of cartilage invasion by laryngeal carcinoma

Cited by 12 publications

References 40 publications

Reliability of a Multidisciplinary Multiparametric Approach in the Surgical Planning of Laryngeal Squamous Cell Carcinomas: A Retrospective Observational Study

Reliability of a Multidisciplinary Multiparametric Approach in the Surgical Planning of Laryngeal Squamous Cell Carcinomas: A Retrospective Observational Study

Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments

The impact of patient preference in the treatment algorithm for recurrent/metastatic head and neck squamous cell carcinoma

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