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Rizzo D, Crescio C, Tramaloni P, De Luca LM, Turra N, Manca A, Crivelli P, Tiana CR, Fara A, Cossu A, Profili S, Scaglione M, Bussu F. Reliability of a Multidisciplinary Multiparametric Approach in the Surgical Planning of Laryngeal Squamous Cell Carcinomas: A Retrospective Observational Study. J Pers Med 2022; 12:jpm12101585. [PMID: 36294725 PMCID: PMC9605535 DOI: 10.3390/jpm12101585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022] Open
Abstract
(1) Background: Endoscopy and morphological imaging are the mainstay of the diagnostic work up of laryngeal squamous cell carcinomas (LSCCs), which can be integrated in a multidisciplinary discussion to obtain a shared pretreatment staging. (2) Methods: A retrospective evaluation of patients, managed at a tertiary university hospital in Italy and submitted to major laryngeal surgery, has been performed. Four different stagings have been defined and compared: epTN (based on endoscopy and physical ENT examination); radTN (based on CT scan); cTN (based on multidisciplinary integration of the two above); pTN based on pathology on surgical samples. Oncological outcomes have been assessed. (3) Results: Three-year relapse free and disease specific survival were 88% and 92.5%, respectively, without significant differences between partial surgeries (n = 13) and total laryngectomies (n = 32). As for the pretreatment staging, and in particular the T classification, the cTN has been revealed as more reliable than epTN and radTN alone in predicting the final pT (Cohen kappa coefficient: 0.7 for cT, 0.44 for radT, 0.32 for epT). In the partial surgery group, we did not record any positive margin nor local recurrence, with a 100% overall and disease-specific survival. (4) Conclusions: The multidisciplinary approach is fundamental in the definition of the primary lesion in LSCC, in particular in order to safely perform surgical preservation of laryngeal function, which is associated with a higher laryngectomy-free survival than irradiation but to a lower salvageability in case of recurrence.
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Affiliation(s)
- Davide Rizzo
- Department of Medical, Surgical and Experimental Science, University of Sassari, 07100 Sassari, Italy
- Division of Otolaryngology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
| | - Claudia Crescio
- Division of Otolaryngology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
| | - Pierangela Tramaloni
- Division of Otolaryngology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
- Correspondence: ; Tel.: +39-07-9228509
| | - Laura M. De Luca
- Division of Otolaryngology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
| | - Nicola Turra
- Residency Program in Otolaryngology, University of Cagliari, 09124 Cagliari, Italy
| | - Alessandra Manca
- Institute of Pathology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
| | - Paola Crivelli
- Institute of Radiology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
| | - Chiara R. Tiana
- Institute of Radiology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
| | - Alberto Fara
- Institute of Radiology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
| | - Antonio Cossu
- Department of Medical, Surgical and Experimental Science, University of Sassari, 07100 Sassari, Italy
- Institute of Pathology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
| | - Stefano Profili
- Institute of Radiology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
| | - Mariano Scaglione
- Department of Medical, Surgical and Experimental Science, University of Sassari, 07100 Sassari, Italy
- Institute of Radiology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
| | - Francesco Bussu
- Department of Medical, Surgical and Experimental Science, University of Sassari, 07100 Sassari, Italy
- Division of Otolaryngology, Azienda Ospedaliero Universitaria, 07100 Sassari, Italy
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