Thyroid cartilage infiltration in advanced laryngeal cancer: prognostic implications and predictive modelling.

IF 2.1 4区医学 Q2 OTORHINOLARYNGOLOGY Acta Otorhinolaryngologica Italica Pub Date : 2024-06-01 Epub Date: 2023-12-29 DOI:10.14639/0392-100X-N2739

Claudia Montenegro, Alberto Paderno, Marco Ravanelli, Carlotta Pessina, Fatima-Ezzahra Nassih, Davide Lancini, Francesca Del Bon, Davide Mattavelli, Davide Farina, Cesare Piazza

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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.

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晚期喉癌的甲状软骨浸润：预后影响和预测模型。

目的：喉软骨侵犯的检测对于喉鳞状细胞癌（LSCC）的分期非常重要。关于预后指标在局部晚期喉癌中的作用，目前仍存在广泛争议。本研究旨在评估甲状软骨浸润体积以及其他组织病理学变量对患者生存期的影响：我们对意大利布雷西亚大学耳鼻咽喉头颈外科在2005年至2021年间接受全喉切除术治疗的74例pT4 LSCC患者进行了回顾性分析。我们将组织学分级、会厌神经（PNI）和淋巴管侵犯（LVI）、甲状软骨浸润和 pTN 分期作为潜在的预后指标。使用3D Slicer软件对术前CT或MRI进行分析，以量化软骨浸润的体积：1年、3年和5年无病生存率（DFS）分别为76%、66%和64%。通过机器学习模型，我们发现甲状软骨浸润的体积与无病生存率高度相关。与浸润体积较小的患者相比，浸润体积较大（> 670 mm3）的患者预后较差：我们的研究证实了LVI在晚期LSCC预后中的重要作用，并且更有创意地强调了甲状软骨浸润体积是另一个有希望的预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Otorhinolaryngologica Italica OTORHINOLARYNGOLOGY-

CiteScore

3.40

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Acta Otorhinolaryngologica Italica first appeared as “Annali di Laringologia Otologia e Faringologia” and was founded in 1901 by Giulio Masini. It is the official publication of the Italian Hospital Otology Association (A.O.O.I.) and, since 1976, also of the Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale (S.I.O.Ch.C.-F.). The journal publishes original articles (clinical trials, cohort studies, case-control studies, cross-sectional surveys, and diagnostic test assessments) of interest in the field of otorhinolaryngology as well as clinical techniques and technology (a short report of unique or original methods for surgical techniques, medical management or new devices or technology), editorials (including editorial guests – special contribution) and letters to the Editor-in-Chief. Articles concerning science investigations and well prepared systematic reviews (including meta-analyses) on themes related to basic science, clinical otorhinolaryngology and head and neck surgery have high priority.