Clinical Versus Pathologic Laryngeal Cancer Staging and the Impact of Stage Change on Outcomes.

The Laryngoscope
Kevin J ContreraPatrick Tassone

Abstract

Evaluate the impact and accuracy of clinical laryngeal cancer staging. Retrospective cohort study. Two hundred sixty-five consecutive patients with laryngeal squamous cell carcinoma who underwent total laryngectomy from 2001 to 2017 were studied. Clinical versus pathologic tumor (T) and nodal (N) categories were compared. Logistic regression and Cox proportional hazards analyzed the association of stage change with perioperative factors and outcomes. Forty-seven patients (17.7%, accuracy = 0.969 ± 0.010 [standard error]) changed between T1-2 and T3-4. Sixty-four patients (24.1%, accuracy = 0.866 ± 0.020) had inaccurate N category. Salvage patients were less likely to have stage change (downstage: odds ratio [OR] = 0.20, 95% confidence interval [CI]: 0.08-0.50, P < .001; upstage: OR = 0.41, 95% CI: 0.23-0.74, P = .003), but more likely to have inaccurate nodal category (39.8% vs. 11.7%, P < .001). Patients with stage change tended to have greater odds of positive/close margins (upstage: OR = 1.78, 95% CI: 0.91-3.5, P = .092) and chemotherapy (downstage: OR = 2.21, 95% CI: 0.80-6.14, P = .128; upstage: OR = 1.87, 95% CI: 0.85-4.11, P = .119). Stage change was associated with recurrence (P = .047) with downstaged patients less lik...Continue Reading

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Citations

Jul 16, 2021·Annals of Surgical Oncology·Michael M LiStephen Y Kang
Sep 30, 2021·The British Journal of Radiology·Amarkumar Dhirajlal RajgorDavid Winston Hamilton

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