Predictive indicators for thyroid cartilage involvement in carcinoma of the larynx seen on spiral computed tomography scans

Fernandes, Rui; Gopalan, P; Spyridakou, C; Joseph, George; Kumar, Manoj

doi:10.1017/s0022215106001939

Cited by 13 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study confirms other studies that show that CT has a low sensitivity for predicting minor cartilage invasion 14–16. Physiological thyroid cartilage ossification results in high‐ density areas that may be just next to the tumor, and the low spatial resolution of CT precludes direct visualization of the inner perichondrium.…”

Section: Discussionsupporting

confidence: 84%

“…These considerations contribute to the difficulties in radiological staging and diagnosis of cartilage invasion, even though imaging is still a necessary adjunct to the clinical evaluation and has been shown to improve staging in selected cases 17. Computed tomography and MRI criteria to optimize the diagnosis of thyroid cartilage invasion are still being assessed, and under‐ or overstaging still occur in 25% to 50% of cases 11, 14–16…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Organ preservation surgery for laryngeal squamous cell carcinoma: Low incidence of thyroid cartilage invasion

et al. 2010

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Organ preservation surgery for laryngeal squamous cell carcinoma: Low incidence of thyroid cartilage invasion

et al. 2010

View full text Add to dashboard Cite

show abstract

“…CT and magnetic resonance imaging criteria to optimize the diagnosis of thyroid cartilage invasion are still being assessed. Understaging or overstaging still occurs in 25-50% of cases (24)(25)(26)(27). It is also important to note that AC involvement for T1 tumors includes several subtypes that are not accounted for in the TNM classification.…”

Section: Discussionmentioning

confidence: 99%

Treatment outcomes of the patients with early glottic cancer treated with initial radiotherapy and salvaged by conservative surgery

Harada

Sasaki

Miyawaki

et al. 2014

Japanese Journal of Clinical Oncology

View full text Add to dashboard Cite

Objective: This retrospective study analyzed the oncological and treatment outcomes of the patients with T1-T2N0 glottic cancer, who were treated with radiotherapy as initial treatment and salvaged by conservative surgery for radiation failure. Methods: Between May 1999 and December 2010, 115 patients with glottic laryngeal cancer were treated at Kobe University Hospital. At presentation, 54 patients had stage T1a disease, 26 had stage T1b disease and 35 had stage T2 disease. Seventy-nine patients were treated with conventional radiotherapy and 36 patients were treated with hyperfractionated radiotherapy as initial treatment. Results: Median duration of follow-up was 61 months. Five-year local control rates of radiotherapy were 92% in T1a, 83% in T1b and 86% in T2. Of 12 patients who developed local recurrence, larynx was successfully preserved in 3 patients by laryngomicrosurgery, 7 patients by vertical partial laryngectomy and one patient by subtotal laryngectomy. Ultimate 5-year laryngeal preservation rate and local control rate of all cases were 99 and 100%, respectively. Conclusions: Present results suggest that initial treatment with radiotherapy salvaged by organ preservation surgery is an effective strategy for laryngeal preservation in the treatment of T1-T2N0 glottic laryngeal cancer.

show abstract

“…Since multiple studies have shown great variation in PPV, NPV, sensitivity and specificity because of variable technical parameters or variable diagnostic criteria, the value of this technology is still somewhat uncertain [2,8]. With the help of appropriately selected and combined criteria such as extralaryngeal tumours, sclerosis, and erosion or lysis, Becker et al [7] showed that CT scanning has significantly improved accuracy of the thyroid cartilage invasion detection, with a PPV of 54-76% and an NPV of 79-89%.…”

Section: Discussionmentioning

confidence: 99%

Overstaging of cartilage invasion by multidetector CT scan for laryngeal cancer and its potential effect on the use of organ preservation with chemoradiation

Li¹,

Bobinski²,

Gandour‐Edwards³

et al. 2011

BJR

View full text Add to dashboard Cite

Objective: The two currently acceptable treatment options for locally advanced laryngeal cancer are total laryngectomy and organ preservation using chemoradiation. To facilitate therapeutic decision making, the accurate pre-treatment evaluation of cartilage invasion is of paramount importance. The purpose of this study was to evaluate the positive predictive value (PPV) and negative predictive value (NPV) of detecting neoplastic cartilage invasion in laryngeal cancer patients using fast-speed multidetector CT (MDCT). Methods: 61 consecutive patients with clinically staged T3 or T4 squamous cell carcinoma of the larynx or hypopharynx who underwent total laryngectomy were analysed. All patients had MDCT of the neck within 2 weeks prior to surgery. Central radiographic and pathological review was performed in an attempt to correlate findings. MDCT invasion of cartilage was graded based on objective criteria. Results: MDCT scan was found to have a PPV of 78% and an NPV of 100% for detection of invasion through cartilage, with sensitivity being 100% and specificity 96%. For detection of any cartilage invasion (minor, major or through cartilage invasion), PPV and NPV were 63% and 92%, respectively. The sensitivity was 85% and specificity was 75%. For the detection of tumour invasion through cartilage or major cartilage invasion, MDCT scan had a PPV of 53% and an NPV of 95%. 47% (9/19) patients were down-staged from T4 to T3 after central pathology review. Conclusion: The low PPV for cartilage destruction using MDCT suggests that a significant proportion of patients who were treated by total laryngectomy could have been appropriately offered organ preservation if more accurately staged at initial diagnosis.

show abstract

Predictive indicators for thyroid cartilage involvement in carcinoma of the larynx seen on spiral computed tomography scans

Cited by 13 publications

References 15 publications

Organ preservation surgery for laryngeal squamous cell carcinoma: Low incidence of thyroid cartilage invasion

Organ preservation surgery for laryngeal squamous cell carcinoma: Low incidence of thyroid cartilage invasion

Treatment outcomes of the patients with early glottic cancer treated with initial radiotherapy and salvaged by conservative surgery

Overstaging of cartilage invasion by multidetector CT scan for laryngeal cancer and its potential effect on the use of organ preservation with chemoradiation

Contact Info

Product

Resources

About