Clinical and pathological staging of primary carcinoma of the larynx

Abstract

Background: Staging of primary carcinoma of the larynx play an important role in surgical management of the disease .This staging depends on the clinical finding and radiological examination , supported by pathological assessment of the excised tumorObjectives: To evaluate the accuracy of clinical and radiological staging Patients’ and methods: Forty-two patients with laryngeal carcinoma were admitted to the ENT Department during the period from June 2009 through October 2010. Each patient was staged by clinical exami¬nation and computed tomography. Evaluation of the results compared to the final diagnosis of staging , based on the pathological staging of specimens of patients who underwent total laryngectomy and the highest T stage was obtained from clinical and CT staging for patients with early laryngeal carcinoma(T1-T2) . Results: The clinical staging of laryngeal carcinoma showed: high accuracy in staging was on glottic tumours (83.3%), especially T1 glottic tumours (100%),(small and superficial lesions), and lower accuracy in staging of supraglottic and transglottic tumors (61.9%) , (55.6% ) respectively.Underestimation of all tumors was 31.4% .The CT staging of laryngeal carcinoma showed: very high accuracy in staging transglottic and supraglottic tumours (100%), (85.7%) respectively in comparison to clinical staging and lower accuracy (75%) in staging glottic tumours.Underestimation of all tumours was 11.5 % of cases (especially small and superficial lesions). Conclusions: High accuracy rate based on clinical examination was found in glottic carcinoma and high accuracy rate based on radiological examination was found in supraglottic carcinoma.Clinical exami¬nation and CT scan are complementary for sraging of carcinoma of larynx .