ENT Updates

Clinical Research

Potential pitfalls of computed tomography in advanced laryngeal cancer

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https://doi.org/10.2399/jmu.2016001005
Aslan, H., Pınar, E., Öztürkcan, S., Aladağ, İbrahim, Karaca Erdoğan, N., Etit, D., Demirkol Tuna, B., İmre, A., Olgun, Y., & Ateş, D. (2016). Potential pitfalls of computed tomography in advanced laryngeal cancer. ENT Updates, 6(1). https://doi.org/10.2399/jmu.2016001005
Volume 6 Issue 1 (2016)
Copyright (c) 2016 Hale Aslan, Ercan Pınar, Sedat Öztürkcan, İbrahim Aladağ, Nezahat Karaca Erdoğan, Demet Etit, Bilge Demirkol Tuna, Abdulkadir İmre, Yüksel Olgun, Düzgün Ateş
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This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors

  • Hale Aslan
    Department of Otorhinolaryngology, School of Medicine, İzmir Katip Çelebi University, İzmir, Turkey
  • Ercan Pınar Department of Otorhinolaryngology, School of Medicine, İzmir Katip Çelebi University, İzmir, Turkey
  • Sedat Öztürkcan Department of Otorhinolaryngology, Atatürk Research and Training Hospital, İzmir Katip Çelebi University, İzmir, Turkey
  • İbrahim Aladağ Department of Otorhinolaryngology, School of Medicine, İzmir Katip Çelebi University, İzmir, Turkey
  • Nezahat Karaca Erdoğan Department of Radiology, Atatürk Research and Training Hospital, İzmir Katip Çelebi University, İzmir, Turkey
  • Demet Etit Department of Pathology, Atatürk Research and Training Hospital, İzmir Katip Çelebi University, İzmir, Turkey
  • Bilge Demirkol Tuna Department of Otorhinolaryngology, Bursa Şevket Yılmaz Research and Training Hospital, Bursa, Turkey
  • Abdulkadir İmre Department of Otorhinolaryngology, Atatürk Training and Research Hospital, İzmir Katip Çelebi University, İzmir, Turkey
  • Yüksel Olgun Department of Otorhinolaryngology, School of Medicine, İzmir Dokuz Eylül University, İzmir, Turkey
  • Düzgün Ateş Department of Otorhinolaryngology, Atatürk Research and Training Hospital, İzmir Katip Çelebi University, İzmir, Turkey

Objective: In laryngeal cancer the most suspected regions of invasion are preepiglottic space (PES), anterior commissure (AC), thyroid cartilage (TC), subglottic region (SR) and extralaryngeal spread (ELS). The objective of this study is to compare the results of preoperative computed tomography (CT) with postoperative histopathologic analysis in these critical regions for the total or partial laryngectomy.

Methods: Eighty-nine patients, who had undergone total laryngectomy with a diagnosis of laryngeal cancer reported that squamous cell cancer (SCC) between 2005 and 2013, were reviewed retrospectively. All the patients, after the first application done total laryngectomy before flexible laryngoscopy, computed tomography for the neck and endoscopic biopsy with direct laryngoscopy. Histopathological results of PES, AC, TC, ELS and SR invasion are compared to preoperative CT findings and determined of specificity, sensitivity, false negative and false positive results and rate of accuracy.

Results: All the patients were male, median age was 67 (range: 48 to 81) years. Fifty-six patients were in T4 and 33 patients in T3 stage. Compared to results between positive CT findings and negative histopathological examination; PES invasion in 41 patients/ 5 patients, AC invasion was found in 38/ 15 patients, TC invasion in 28/16 patients, SR invasion in 49/ 9 patients and ELS invasion in 25 /7 patients. Accuracy rate of computed tomography in these regions are 85%, 64%, 76%, 79%, and 83%, respectively. All the results especially thyroid cartilage invasion were statistically significant.

Conclusion: In all regions invasion, CT has a low diagnostic reliability in high-grade laryngeal cancer in our study. We suggested that histopathological results are the gold standard intraoperatively for determining total or partial laryngectomy.

Keywords:

Computed tomography larynx carcinoma accuracy