PMID- 30360641
OWN - NLM
STAT- MEDLINE
DCOM- 20190228
LR  - 20190228
IS  - 1943-572X (Electronic)
IS  - 0003-4894 (Linking)
VI  - 128
IP  - 1
DP  - 2019 Jan
TI  - A Critical Reappraisal of Primary and Recurrent Advanced Laryngeal Cancer 
      Staging.
PG  - 36-43
LID - 10.1177/0003489418806915 [doi]
AB  - OBJECTIVES: Laryngeal squamous cell carcinoma (LSCC) can involve different 
      anatomic subunits with peculiar surgical and prognostic implications. Despite 
      conflicting outcomes for the same stage of disease, the current staging system 
      considers different lesions in a single cluster. The aim of this study was to 
      critically discuss clinical and pathologic staging of primary and recurrent 
      advanced LSCC in order to define current staging pitfalls that impede a precise 
      and tailored treatment strategy. METHODS: Thirty patients who underwent total 
      laryngectomy in the past 3 years for primary and recurrent advanced squamous cell 
      LSCC were analyzed, comparing endoscopic, imaging, and pathologic findings. 
      Involvement of the different laryngeal subunits, vocal-fold motility, and 
      spreading pattern of the tumor were blindly analyzed. The diagnostic accuracy and 
      differences between clinicoradiologic and pathologic findings were studied with 
      standard statistical analysis. RESULTS: Discordant staging was performed in 10% 
      of patients, and thyroid and arytenoid cartilage were the major diagnostic 
      pitfalls. Microscopic arytenoid involvement was significantly more present in 
      case of vocal-fold fixation ( P = .028). Upstaging was influenced by paraglottic 
      and pre-epiglottic space cancer involvement, posterior commissure, subglottic 
      region, arytenoid cartilage, and penetration of thyroid cartilage; on the 
      contrary, involvement of the inner cortex or extralaryngeal spread tended to be 
      down-staged. Radiation-failed tumors less frequently involved the posterior third 
      of the paraglottic space ( P = .022) and showed a significantly worse pattern of 
      invasion ( P < .001). CONCLUSIONS: Even with the most recent technologies, 1 in 
      10 patients with advanced LSCC in this case series was differently staged on 
      clinical examination, with cartilage involvement representing the main diagnostic 
      pitfall.
FAU - Locatello, Luca Giovanni
AU  - Locatello LG
AUID- ORCID: 0000-0002-1879-5580
AD  - 1 Division of Otorhinolaryngology, Department of Surgery and Translational 
      Medicine, University of Florence, Florence, Italy.
FAU - Pietragalla, Michele
AU  - Pietragalla M
AUID- ORCID: 0000-0003-4589-7109
AD  - 2 Division of Radiology, Department of Surgery and Translational Medicine, 
      University of Florence, Florence, Italy.
FAU - Taverna, Cecilia
AU  - Taverna C
AD  - 3 Institute of Pathology, Department of Surgery and Translational Medicine, 
      University of Florence, Florence, Italy.
FAU - Bonasera, Luigi
AU  - Bonasera L
AD  - 2 Division of Radiology, Department of Surgery and Translational Medicine, 
      University of Florence, Florence, Italy.
FAU - Massi, Daniela
AU  - Massi D
AD  - 3 Institute of Pathology, Department of Surgery and Translational Medicine, 
      University of Florence, Florence, Italy.
FAU - Mannelli, Giuditta
AU  - Mannelli G
AUID- ORCID: 0000-0001-7079-3964
AD  - 1 Division of Otorhinolaryngology, Department of Surgery and Translational 
      Medicine, University of Florence, Florence, Italy.
LA  - eng
PT  - Journal Article
DEP - 20181026
PL  - United States
TA  - Ann Otol Rhinol Laryngol
JT  - The Annals of otology, rhinology, and laryngology
JID - 0407300
SB  - IM
MH  - Aged
MH  - Biopsy/methods/statistics & numerical data
MH  - *Carcinoma, Squamous Cell/diagnosis/pathology/therapy
MH  - *Chemoradiotherapy/adverse effects/methods/statistics & numerical data
MH  - Data Accuracy
MH  - Female
MH  - Head and Neck Neoplasms/diagnosis/pathology/therapy
MH  - Humans
MH  - Italy
MH  - *Laryngeal Neoplasms/diagnosis/pathology/therapy
MH  - *Laryngectomy/adverse effects/methods/statistics & numerical data
MH  - *Laryngoscopy/methods/statistics & numerical data
MH  - *Larynx/diagnostic imaging/pathology/physiopathology
MH  - Male
MH  - Neoplasm Invasiveness/diagnostic imaging/physiopathology
MH  - *Neoplasm Recurrence, Local/diagnosis/pathology/therapy
MH  - *Neoplasm Staging/methods/standards
MH  - Prognosis
MH  - Sensitivity and Specificity
OTO - NOTNLM
OT  - TNM
OT  - cancer staging
OT  - head and neck cancer
OT  - laryngeal cancer
OT  - laryngology
EDAT- 2018/10/27 06:00
MHDA- 2019/03/01 06:00
CRDT- 2018/10/27 06:00
PHST- 2018/10/27 06:00 [pubmed]
PHST- 2019/03/01 06:00 [medline]
PHST- 2018/10/27 06:00 [entrez]
AID - 10.1177/0003489418806915 [doi]
PST - ppublish
SO  - Ann Otol Rhinol Laryngol. 2019 Jan;128(1):36-43. doi: 10.1177/0003489418806915. 
      Epub 2018 Oct 26.