[Efficacy of clinical examination and computed tomography at T-staging of laryngeal carcinoma].

OBJECTIVES

The purpose of this study is to investigate the accuracy rates of tumor T-staging and the efficacy of methods used at T-staging.

PATIENTS AND METHODS

Forty-seven laryngeal carcinoma patients (6 females, 41 males; mean age 57.9+/-9.8 years; range 38 to 81 years) who underwent surgery at Haydarpaşa Numune Education and Research Hospital 2nd Ear Nose Throat Clinic between March 2003 and June 2008 were included in the study. T-staging of the tumors were separately determined according to their clinical examination, computed tomography (CT) findings, and their correlation between these methods. Staging according to histopathological examination was accepted as real accurate staging. Rates of accurate staging according to postoperative histopathological examination results were evaluated under guidance of the literature.

RESULTS

When their accuracy rates in determining histopathological T-stages of tumors were compared, there were no significant differences between the methods. The rates of accuracy in determining histopathologic T-stage of tumors were 40% by clinical examination; 66% by CT; and 76% when both methods were used together. The most successful results were obtained at the tumors of glottic region. Among the patients whose tumors had been staged inaccurately by clinical examination, 71% were underestimated while 29% were overestimated. Underestimation and overestimation of stagings were found to be 37% and 63%, respectively, with CT examination.

CONCLUSION

Success of staging increases when clinical examination is used in together with CT. While there is a tendency towards underestimation of T-stage when staging is done only by means of clinical examination, this tendency is towards overestimation when CT is used alone. Thus, combination of clinical examination findings with CT is necessary for an accurate T-staging of a laryngeal cancer.