en
Scientific article
English

Staging of laryngeal cancer: endoscopy, computed tomography and magnetic resonance versus histopathology

Published inEuropean archives of oto-rhino-laryngology, vol. 254 Suppl 1, p. S117-122
Publication date1997
Abstract

An accurate pretherapeutic staging of laryngeal cancer is required for optimal treatment planning and for evaluation and comparison of the results of different treatment modalities. In this study, 45 consecutive patients with neoplasms of the larynx, treated surgically, were included in a prospective pretherapeutic staging protocol that included indirect laryngoscopy, direct microlaryngoscopy, contrast-enhanced computed tomography (CT) and Gd-DTPA-enhanced magnetic resonance imaging (MRI). The surgical specimens were cut in whole-organ slices parallel to the plane of the axial CT and MR images. The histologic findings were then compared with clinical findings, CT and MRI. These findings showed that clinical evaluation failed to identify tumor invasion of the laryngeal cartilages and extralaryngeal soft tissues, resulting in a low staging accuracy (55%). Many pT4 tumors were clinically understaged. The combination of clinical/endoscopic evaluation and either CT or MRI resulted in a significantly improved staging accuracy (80% vs 87%, respectively). MRI was significantly more sensitive but less specific than CT in detecting neoplastic cartilage invasion. MRI tended to overestimate neoplastic cartilage invasion to possibly result in overtreatment, while CT was found to underestimate neoplastic cartilage invasion and could lead to inadequate therapeutic decisions.

Keywords
  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Protocols
  • Contrast Media
  • Decision Making
  • Female
  • Gadolinium/diagnostic use
  • Gadolinium DTPA
  • Humans
  • Image Enhancement
  • Laryngeal Cartilages/pathology
  • Laryngeal Neoplasms/pathology/surgery
  • Laryngoscopy
  • Larynx/pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neck/pathology
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Organometallic Compounds/diagnostic use
  • Patient Care Planning
  • Pentetic Acid/analogs & derivatives/diagnostic use
  • Prospective Studies
  • Radiographic Image Enhancement
  • Tomography, X-Ray Computed
Citation (ISO format)
ZBÄREN, P, BECKER, Minerva, LÄNG, H. Staging of laryngeal cancer: endoscopy, computed tomography and magnetic resonance versus histopathology. In: European archives of oto-rhino-laryngology, 1997, vol. 254 Suppl 1, p. S117–122. doi: 10.1007/BF02439740
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Article (Published version)
accessLevelRestricted
Identifiers
ISSN of the journal0937-4477
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