Laryngology
Published: 2023-12-29
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Thyroid cartilage infiltration in advanced laryngeal cancer: prognostic implications and predictive modelling

 Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy
 Unit of Otorhinolaryngology, IRCCS Humanitas Research Hospital, Milan, Italy
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy; Unit of Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy; Unit of Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy
Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy
Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy
Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy
Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy; Unit of Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy
 Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy
cartilage infiltration thyroid cartilage laryngeal cancer prognostic factors machine learning predictive model

Abstract

Objective. Detection of laryngeal cartilage invasion is of great importance in staging of laryngeal squamous cell carcinoma (LSCC). The role of prognosticators in locally advanced laryngeal cancer are still widely debated. This study aimed to assess the impact of volume of thyroid cartilage infiltration, as well as other histopathologic variables, on patient survival.
Materials and methods. We retrospectively analysed 74 patients affected by pT4 LSCC and treated with total laryngectomy between 2005 and 2021 at the Department of Otorhinolaryngology – Head and Neck Surgery of the University of Brescia, Italy. We considered as potential prognosticators histological grade, perineural (PNI) and lympho-vascular invasion (LVI), thyroid cartilage infiltration, and pTN staging. Pre-operative CT or MRI were analysed to quantify the volume of cartilage infiltration using 3D Slicer software.
Results. The 1-, 3-, and 5-year disease free survivals (DFS) were 76%, 66%, and 64%, respectively. Using machine learning models, we found that the volume of thyroid cartilage infiltration had high correlation with DFS. Patients with a higher volume (> 670 mm3) of infiltration had a worse prognosis compared to those with a lower volume.
Conclusions. Our study confirms the essential role of LVI as prognosticator in advanced LSCC and, more innovatively, highlights the volume of thyroid cartilage infiltration as another promising prognostic factor.

Affiliations

Claudia Montenegro

 Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy

Alberto Paderno

 Unit of Otorhinolaryngology, IRCCS Humanitas Research Hospital, Milan, Italy

Marco Ravanelli

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy; Unit of Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy

Carlotta Pessina

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy; Unit of Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy

Fatima-Ezzahra Nassih

Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy

Davide Lancini

Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy

Francesca Del Bon

Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy

Davide Mattavelli

Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy

Davide Farina

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy; Unit of Radiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy

Cesare Piazza

 Unit of Otorhinolaryngology – Head and Neck Surgery, ASST Spedali Civili of Brescia, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, School of Medicine, Brescia, Italy

Copyright

© Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale , 2024

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