PMID- 38520756 OWN - NLM STAT- MEDLINE DCOM- 20240430 LR - 20240516 IS - 1879-0593 (Electronic) IS - 1368-8375 (Linking) VI - 152 DP - 2024 May TI - How reliable is assessment of true vocal cord-arytenoid unit mobility in patients affected by laryngeal cancer? a multi-institutional study on 366 patients from the ARYFIX collaborative group. PG - 106744 LID - S1368-8375(24)00062-9 [pii] LID - 10.1016/j.oraloncology.2024.106744 [doi] AB - PURPOSE: In clinical practice the assessment of the "vocal cord-arytenoid unit" (VCAU) mobility is crucial in the staging, prognosis, and choice of treatment of laryngeal squamous cell carcinoma (LSCC). The aim of the present study was to measure repeatability and reliability of clinical assessment of VCAU mobility and radiologic analysis of posterior laryngeal extension. METHODS: In this multi-institutional retrospective study, patients with LSCC-induced impairment of VCAU mobility who received curative treatment were included; pre-treatment endoscopy and contrast-enhanced imaging were collected and evaluated by raters. According to their evaluations, concordance, number of assigned categories, and inter- and intra-rater agreement were calculated. RESULTS: Twenty-two otorhinolaryngologists evaluated 366 videolaryngoscopies (total evaluations: 2170) and 6 radiologists evaluated 237 imaging studies (total evaluations: 477). The concordance of clinical rating was excellent in only 22.7% of cases. Overall, inter- and intra-rater agreement was weak. Supraglottic cancers and transoral endoscopy were associated with the lowest inter-observer reliability values. Radiologic inter-rater agreement was low and did not vary with imaging technique. Intra-rater reliability of radiologic evaluation was optimal. CONCLUSIONS: The current methods to assess VCAU mobility and posterior extension of LSCC are flawed by weak inter-observer agreement and reliability. Radiologic evaluation was characterized by very high intra-rater agreement, but weak inter-observer reliability. The relevance of VCAU mobility assessment in laryngeal oncology should be re-weighted. Patients affected by LSCC requiring imaging should be referred to dedicated radiologists with experience in head and neck oncology. CI - Copyright (c) 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved. FAU - Ferrari, M AU - Ferrari M AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. Electronic address: marco.ferrari@unipd.it. FAU - Mularoni, F AU - Mularoni F AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. FAU - Taboni, S AU - Taboni S AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. FAU - Crosetti, E AU - Crosetti E AD - Otorhinolaryngology Department - Head Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy. FAU - Pessina, C AU - Pessina C AD - Radiology Unit, Sant'Antonio Hospital, University of Padova, Padova, Italy. FAU - Carobbio, A L C AU - Carobbio ALC AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. FAU - Montalto, N AU - Montalto N AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. FAU - Marchi, F AU - Marchi F AD - Unit of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy. FAU - Vural, A AU - Vural A AD - Otorhinolaryngology Unit, Istanbul University - Cerrahpasa, Cerrahpasa Medical Faculty, Istanbul, Turkey. FAU - Paderno, A AU - Paderno A AD - IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy. FAU - Caprioli, S AU - Caprioli S AD - Radiology Unit, San Martino Hospital, Genoa, Italy. FAU - Gaudioso, P AU - Gaudioso P AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. FAU - Fermi, M AU - Fermi M AD - Otorhinolaryngology Unit, Azienda Ospedaliera Universitaria di Bologna IRCCS, Bologna, Italy; Department of Surgical and Medical Sciences, University of Bologna, Bologna, Italy. FAU - Rigoni, F AU - Rigoni F AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. FAU - Saccardo, T AU - Saccardo T AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. FAU - Contro, G AU - Contro G AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. FAU - Ruaro, A AU - Ruaro A AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. FAU - Lo Manto, A AU - Lo Manto A AD - Otorhinolaryngology Unit, Infermi Hospital, Rimini, Italy. FAU - Varago, C AU - Varago C AD - Otorhinolaryngology Unit, Vittorio Veneto Hospital, Treviso, Italy. FAU - Baldovin, M AU - Baldovin M AD - Otorhinolaryngology Unit, San Martino di Belluno Hospital, Belluno, Italy. FAU - Bandolin, L AU - Bandolin L AD - Otorhinolaryngology Unit, Hospital of Santorso, Vicenza, Italy. FAU - Filauro, M AU - Filauro M AD - Unit of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy. FAU - Sampieri, C AU - Sampieri C AD - Department of Experimental Medicine (DIMES), University of Genoa, Italy; Unit of Head and Neck Tumors, Hospital Clinic, Barcelona, Spain. FAU - Missale, F AU - Missale F AD - Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, 6202 AZ Maastricht, the Netherlands. FAU - Ioppi, A AU - Ioppi A AD - Department of Otorhinolaryngology-Head and Neck Surgery, "S. Chiara" Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy. FAU - Carta, F AU - Carta F AD - Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy. FAU - Ramanzin, M AU - Ramanzin M AD - Radiology Unit, Hospital of Vicenza, Vicenza, Italy. FAU - Ravanelli, M AU - Ravanelli M AD - Radiology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy. FAU - Maiolo, V AU - Maiolo V AD - Pediatric and Adult Cardiothoracic and Vascular, Oncohematologic and Emergency Radiology Unit (IRCCS AOUBO), University of Bologna, Italy. FAU - Bertotto, I AU - Bertotto I AD - Radiology Unit, IRCCS Istituto di Candiolo, Turin, Italy. FAU - Del Bon, F AU - Del Bon F AD - Otorhinolaryngology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy. FAU - Lancini, D AU - Lancini D AD - Otorhinolaryngology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy. FAU - Mariani, C AU - Mariani C AD - Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy. FAU - Marrosu, V AU - Marrosu V AD - Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy. FAU - Tatti, M AU - Tatti M AD - Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy. FAU - Cagli, S AU - Cagli S AD - Otorhinolaryngology Unit, Erciyes University, Kayseri, Turkey. FAU - Yuce, I AU - Yuce I AD - Otorhinolaryngology Unit, Erciyes University, Kayseri, Turkey. FAU - Gundog, M AU - Gundog M AD - Department of Radiation Oncology, Erciyes University, Kayseri, Turkey. FAU - Dogan, S AU - Dogan S AD - Department of Radiology, Erciyes University, Kayseri, Turkey. FAU - Anile, G AU - Anile G AD - Unit of Medical Oncology 2, "Istituto Oncologico Veneto", Padova, Italy. FAU - Gottardi, C AU - Gottardi C AD - Unit of Medical Oncology 2, "Istituto Oncologico Veneto", Padova, Italy. FAU - Busato, F AU - Busato F AD - Unit of Radiation Oncology, Policlinico Abano, Padova, Italy. FAU - Vallin, A AU - Vallin A AD - Unit of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy. FAU - Gennarini, F AU - Gennarini F AD - Otorhinolaryngology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy. FAU - Bossi, P AU - Bossi P AD - Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy. FAU - Ghi, M G AU - Ghi MG AD - Unit of Medical Oncology 2, "Istituto Oncologico Veneto", Padova, Italy. FAU - Lionello, M AU - Lionello M AD - Otorhinolaryngology Unit, Vittorio Veneto Hospital, Treviso, Italy. FAU - Zanoletti, E AU - Zanoletti E AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. FAU - Marioni, G AU - Marioni G AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. FAU - Maroldi, R AU - Maroldi R AD - Radiology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy. FAU - Mattioli, F AU - Mattioli F AD - Otorhinolaryngology Unit, University of Modena, Modena, Italy. FAU - Puxeddu, R AU - Puxeddu R AD - Otorhinolaryngology Unit, Azienda Ospedaliero-Universitaria di Cagliari, Cagliari, Italy; King's College Hospital London, Dubai, United Arab Emirates. FAU - Bertolin, A AU - Bertolin A AD - Otorhinolaryngology Unit, Vittorio Veneto Hospital, Treviso, Italy. FAU - Presutti, L AU - Presutti L AD - Otorhinolaryngology Unit, Azienda Ospedaliera Universitaria di Bologna IRCCS, Bologna, Italy; Department of Surgical and Medical Sciences, University of Bologna, Bologna, Italy. FAU - Piazza, C AU - Piazza C AD - Otorhinolaryngology Unit, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy. FAU - Succo, G AU - Succo G AD - Otorhinolaryngology Department - Head Neck Cancer Unit, San Giovanni Bosco Hospital, Turin, Italy; Oncology Department, University of Turin, Turin, Italy. FAU - Peretti, G AU - Peretti G AD - Unit of Otorhinolaryngology, Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16121 Genoa, Italy; Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, Genoa, Italy. FAU - Nicolai, P AU - Nicolai P AD - Otorhinolaryngology and Head and Neck Unit, Department of Neuroscience, Azienda Ospedale Universita di Padova, Padova, Italy. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20240322 PL - England TA - Oral Oncol JT - Oral oncology JID - 9709118 SB - IM MH - Humans MH - *Laryngeal Neoplasms/diagnostic imaging/pathology MH - Male MH - Female MH - Middle Aged MH - Aged MH - Retrospective Studies MH - *Vocal Cords/diagnostic imaging/physiopathology MH - Adult MH - Reproducibility of Results MH - Aged, 80 and over MH - Laryngoscopy/methods MH - Carcinoma, Squamous Cell/diagnostic imaging/pathology OTO - NOTNLM OT - Agreement OT - Arytenoid OT - Endoscopy OT - Imaging OT - Larynx OT - Mobility OT - Reliability OT - Squamous cell carcinoma OT - Vocal cord COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2024/03/24 00:42 MHDA- 2024/04/30 06:46 CRDT- 2024/03/23 19:05 PHST- 2024/01/10 00:00 [received] PHST- 2024/03/01 00:00 [revised] PHST- 2024/03/05 00:00 [accepted] PHST- 2024/04/30 06:46 [medline] PHST- 2024/03/24 00:42 [pubmed] PHST- 2024/03/23 19:05 [entrez] AID - S1368-8375(24)00062-9 [pii] AID - 10.1016/j.oraloncology.2024.106744 [doi] PST - ppublish SO - Oral Oncol. 2024 May;152:106744. doi: 10.1016/j.oraloncology.2024.106744. Epub 2024 Mar 22.