PMID- 37042776
OWN - NLM
STAT- MEDLINE
DCOM- 20230414
LR  - 20230524
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 133
IP  - 5
DP  - 2023 May
TI  - Paraglottic Space Invasion in Glottic Laryngeal Cancer: A Clinical-Pathological 
      Study.
PG  - 1184-1190
LID - 10.1002/lary.30335 [doi]
AB  - OBJECTIVE: This study aims to prospectively compare endoscopic, radiological, and 
      pathological features of a cohort of patients with glottic laryngeal squamous 
      cell carcinoma (LSCC) undergoing open partial horizontal laryngectomy (OPHL) type 
      II/III or total laryngectomy to better understand the reliability of preoperative 
      endoscopy and computed tomography (CT) to predict the inferior paraglottic space 
      (iPGS) involvement. METHODS: We prospectively compared the endoscopic, 
      radiological, and pathological findings in patients with glottic LSCC who 
      underwent OPHL II/III, or total laryngectomy. RESULTS: Endoscopy achieved a 
      diagnostic accuracy of 87.2% for the anterior iPGS (iPGSa) and 86.1% for the 
      posterior iPGS (iPGSp). There was no statistically significant difference in 
      terms of histopathologic iPGSa involvement between reduced (85%-17/20 pts) and 
      absent (92%-24/26 pts) vocal cord mobility (p = 0.39). CT alone did not improve 
      the diagnostic performance of the endoscopy, reaching a diagnostic accuracy of 
      62.9% and 73.7% for the iPGSa and iPGSp, respectively. When endoscopy and CT were 
      combined, the diagnostic performance improved for the iPGSp, achieving a 
      sensitivity (Se), specificity (Spe), positive predictive value (PPV), and 
      negative predictive value (NPV) of 100%, 89.8%, 68.7%, and 100%, respectively. On 
      the contrary, the combination of CT and endoscopy improved only the Se and NPV 
      for the iPGSa with respect to the sole endoscopic assessment. CONCLUSIONS: 
      Whenever motility impairment is present, a histopathologic invasion of the iPGS 
      should be suspected. Endoscopic assessment of laryngeal motility achieved a 
      satisfactory value of Se, Spe, PPV, and NPV in predicting the involvement of the 
      iPGS. CT scan is still the mainstay imaging technique in the clinical staging of 
      patients with LSCC. LEVEL OF EVIDENCE: 4 Laryngoscope, 133:1184-1190, 2023.
CI  - (c) 2022 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf 
      of The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Fermi, Matteo
AU  - Fermi M
AUID- ORCID: 0000-0002-2727-0321
AD  - Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Azienda 
      Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna, 
      Italy.
AD  - Department of Specialist, Diagnostic and Experimental Medicine (DIMES), Alma 
      Mater Studiorum, Universita di Bologna, Bologna, Italy.
FAU - Lo Manto, Alfredo
AU  - Lo Manto A
AUID- ORCID: 0000-0002-2928-2051
AD  - Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of 
      Modena, Modena, Italy.
FAU - Di Massa, Gianluca
AU  - Di Massa G
AD  - Department of Pathology, University Hospital of Modena, Modena, Italy.
FAU - Gallo, Graziana
AU  - Gallo G
AD  - Department of Pathology, University Hospital of Modena, Modena, Italy.
FAU - Lupi, Massimo
AU  - Lupi M
AD  - Department of Pathology, University Hospital of Modena, Modena, Italy.
FAU - Maiolo, Vincenzo
AU  - Maiolo V
AUID- ORCID: 0000-0001-8585-1792
AD  - Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 
      Policlinico S.Orsola-Malpighi, Bologna, Italy.
FAU - Montrone, Grazia
AU  - Montrone G
AUID- ORCID: 0000-0002-1052-0742
AD  - Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 
      Policlinico S.Orsola-Malpighi, Bologna, Italy.
FAU - Lovato, Luigi
AU  - Lovato L
AD  - Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 
      Policlinico S.Orsola-Malpighi, Bologna, Italy.
FAU - Presutti, Livio
AU  - Presutti L
AUID- ORCID: 0000-0002-2752-132X
AD  - Department of Otorhinolaryngology, Head and Neck Surgery, IRCCS Azienda 
      Ospedaliero-Universitaria di Bologna, Policlinico S.Orsola-Malpighi, Bologna, 
      Italy.
AD  - Department of Specialist, Diagnostic and Experimental Medicine (DIMES), Alma 
      Mater Studiorum, Universita di Bologna, Bologna, Italy.
FAU - Mattioli, Francesco
AU  - Mattioli F
AUID- ORCID: 0000-0002-1481-668X
AD  - Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of 
      Modena, Modena, Italy.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220806
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Humans
MH  - *Laryngeal Neoplasms/diagnostic imaging/surgery
MH  - Reproducibility of Results
MH  - *Carcinoma, Squamous Cell/diagnostic imaging/surgery
MH  - Neoplasm Staging
MH  - Glottis/surgery
MH  - Squamous Cell Carcinoma of Head and Neck/pathology
MH  - Laryngectomy/methods
MH  - *Head and Neck Neoplasms/surgery
MH  - Retrospective Studies
OTO - NOTNLM
OT  - CT scan
OT  - endoscopy
OT  - glottis
OT  - head and neck neoplasms
OT  - imaging
OT  - laryngeal neoplasms
OT  - laryngectomy
OT  - laryngoscopy
OT  - squamous cell carcinoma of head and neck
OT  - x-ray
EDAT- 2023/04/13 06:00
MHDA- 2023/04/14 06:42
CRDT- 2023/04/12 10:06
PHST- 2022/07/18 00:00 [revised]
PHST- 2022/03/11 00:00 [received]
PHST- 2022/07/25 00:00 [accepted]
PHST- 2023/04/14 06:42 [medline]
PHST- 2023/04/12 10:06 [entrez]
PHST- 2023/04/13 06:00 [pubmed]
AID - 10.1002/lary.30335 [doi]
PST - ppublish
SO  - Laryngoscope. 2023 May;133(5):1184-1190. doi: 10.1002/lary.30335. Epub 2022 Aug 
      6.