Computed tomography (CT) scans cannot always determine whether laryngeal cancer has penetrated thyroid cartilage or spread beyond the larynx, suggesting that better methods of pretreatment assessment are needed. These results were recently published in the Journal of Clinical Oncology.
In order to determine appropriate treatment in patients with larynx cancer, clinicians must determine the extent or spread of disease. In larynx cancer patients, it is particularly important to be able to determine whether the cancer has spread through the cartilage in order to determine whether or not patients are candidates for treatment that preserves the larynx. Imaging with tools such as CT may be used to help determine which patients are candidates for larynx-preserving treatment and which patients require surgical removal of the larynx.
In the current study, researchers evaluated the accuracy of CT scans in determining the extent of spread in patients with larynx cancer. CT scans were taken prior to laryngectomy in 107 patients. Findings from the CT scans were compared with the surgically removed specimens to determine accuracy. The radiologists and pathologists were particularly interested in measuring thyroid cartilage penetration and extralaryngeal spread.
- CT identified 59% of cases with thyroid cartilage penetration and 49% of cases of extralaryngeal spread.
- When CT suggested cartilage penetration the finding was confirmed in 74% of cases. When CT suggested extralaryngeal spread the finding was confirmed in 81% of cases.
The researchers concluded that more accurate methods of determining larynx cancer spread are necessary in order to determine which patients are appropriate candidates for larynx-preserving treatment.
 Beitler JJ, Muller S, Grist WJ, et al. Prognostic Accuracy of Computed Tomography Findings for Patients With Laryngeal Cancer Undergoing Laryngectomy. Journal of Clinical Oncology. 2010;28:2318-2322.?
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