How reliably can computed tomography predict thyroid invasion prior to laryngectomy?
Objectives/Hypothesis There is little evidence to support the removal of thyroid tissue during total laryngectomy. Although oncological control of the tumor is the priority, thyroidectomy can lead to hypothyroidism and hypoparathyroidism. This study aimed to test the usefulness of preoperative compu...
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| Veröffentlicht in: | The Laryngoscope 2018-05, Vol.128 (5), p.1099-1102 |
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| creator | Harris, Andrew S. Passant, Carl D. Ingrams, Duncan R. |
| description | Objectives/Hypothesis
There is little evidence to support the removal of thyroid tissue during total laryngectomy. Although oncological control of the tumor is the priority, thyroidectomy can lead to hypothyroidism and hypoparathyroidism. This study aimed to test the usefulness of preoperative computed tomography in predicting histological invasion of the thyroid.
Study Design
Ambispective cohort study.
Methods
All patients undergoing total laryngectomy for squamous cell carcinoma at one center from 2006 to 2016 were included. Data were recorded prospectively as part of the patients' standard care, but were collated retrospectively, giving this study an ambispective design. The histology report for thyroid invasion was taken as the gold standard. The computed tomography report was categorized by invasion of tumor into intralaryngeal, laryngeal cartilage involvement, and extralaryngeal tissues.
Results
Seventy‐nine patients were included. Nine patients had thyroid involvement on histology, translating to an incidence of 11.29% in this population. The positive predictive value for cartilage involvement on computed tomography for thyroid invasion was 52.9% (95% confidence interval [CI]: 28.5%‐76.1%) and the negative predictive value was 100% (95% CI: 92.7%‐100%).The positive predictive value for extralaryngeal spread on computed tomography for thyroid involvement was 100% (95% CI: 62.9%‐100%), and the negative predictive value was also 100% (95% CI: 93.5%‐100%).
Conclusions
This study has shown that preoperative computed tomography is an effective method of ruling out thyroid gland invasion. The absence of extralaryngeal spread on computed tomography has been shown to be the most useful finding, with a high negative predictive value and a narrow 95% CI.
Level of Evidence
4. Laryngoscope, 128:1099–1102, 2018 |
| doi_str_mv | 10.1002/lary.26927 |
| format | Article |
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There is little evidence to support the removal of thyroid tissue during total laryngectomy. Although oncological control of the tumor is the priority, thyroidectomy can lead to hypothyroidism and hypoparathyroidism. This study aimed to test the usefulness of preoperative computed tomography in predicting histological invasion of the thyroid.
Study Design
Ambispective cohort study.
Methods
All patients undergoing total laryngectomy for squamous cell carcinoma at one center from 2006 to 2016 were included. Data were recorded prospectively as part of the patients' standard care, but were collated retrospectively, giving this study an ambispective design. The histology report for thyroid invasion was taken as the gold standard. The computed tomography report was categorized by invasion of tumor into intralaryngeal, laryngeal cartilage involvement, and extralaryngeal tissues.
Results
Seventy‐nine patients were included. Nine patients had thyroid involvement on histology, translating to an incidence of 11.29% in this population. The positive predictive value for cartilage involvement on computed tomography for thyroid invasion was 52.9% (95% confidence interval [CI]: 28.5%‐76.1%) and the negative predictive value was 100% (95% CI: 92.7%‐100%).The positive predictive value for extralaryngeal spread on computed tomography for thyroid involvement was 100% (95% CI: 62.9%‐100%), and the negative predictive value was also 100% (95% CI: 93.5%‐100%).
Conclusions
This study has shown that preoperative computed tomography is an effective method of ruling out thyroid gland invasion. The absence of extralaryngeal spread on computed tomography has been shown to be the most useful finding, with a high negative predictive value and a narrow 95% CI.
Level of Evidence
4. Laryngoscope, 128:1099–1102, 2018</description><identifier>ISSN: 0023-852X</identifier><identifier>EISSN: 1531-4995</identifier><identifier>DOI: 10.1002/lary.26927</identifier><identifier>PMID: 28988411</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell - diagnostic imaging ; Carcinoma, Squamous Cell - surgery ; computed tomography scan ; computerized axial tomography scan ; Female ; Health risk assessment ; Histology ; Humans ; Laryngeal Neoplasms - diagnostic imaging ; Laryngeal Neoplasms - surgery ; Laryngectomy ; Male ; Middle Aged ; Neoplasm Invasiveness - diagnostic imaging ; Neoplasm Invasiveness - pathology ; Predictive Value of Tests ; Prospective Studies ; Retrospective Studies ; Squamous cell carcinoma ; Thyroid gland ; Thyroid Gland - diagnostic imaging ; Thyroid Gland - pathology ; thyroidectomy ; Tomography, X-Ray Computed</subject><ispartof>The Laryngoscope, 2018-05, Vol.128 (5), p.1099-1102</ispartof><rights>2017 The American Laryngological, Rhinological and Otological Society, Inc.</rights><rights>2018 The American Laryngological, Rhinological and Otological Society, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3577-f0c531ad99989bf2ac1e49115713e23f6cb3a361d84d58c2695d8d78555036d63</citedby><cites>FETCH-LOGICAL-c3577-f0c531ad99989bf2ac1e49115713e23f6cb3a361d84d58c2695d8d78555036d63</cites><orcidid>0000-0003-1853-0045</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Flary.26927$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Flary.26927$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28988411$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Harris, Andrew S.</creatorcontrib><creatorcontrib>Passant, Carl D.</creatorcontrib><creatorcontrib>Ingrams, Duncan R.</creatorcontrib><title>How reliably can computed tomography predict thyroid invasion prior to laryngectomy?</title><title>The Laryngoscope</title><addtitle>Laryngoscope</addtitle><description>Objectives/Hypothesis
There is little evidence to support the removal of thyroid tissue during total laryngectomy. Although oncological control of the tumor is the priority, thyroidectomy can lead to hypothyroidism and hypoparathyroidism. This study aimed to test the usefulness of preoperative computed tomography in predicting histological invasion of the thyroid.
Study Design
Ambispective cohort study.
Methods
All patients undergoing total laryngectomy for squamous cell carcinoma at one center from 2006 to 2016 were included. Data were recorded prospectively as part of the patients' standard care, but were collated retrospectively, giving this study an ambispective design. The histology report for thyroid invasion was taken as the gold standard. The computed tomography report was categorized by invasion of tumor into intralaryngeal, laryngeal cartilage involvement, and extralaryngeal tissues.
Results
Seventy‐nine patients were included. Nine patients had thyroid involvement on histology, translating to an incidence of 11.29% in this population. The positive predictive value for cartilage involvement on computed tomography for thyroid invasion was 52.9% (95% confidence interval [CI]: 28.5%‐76.1%) and the negative predictive value was 100% (95% CI: 92.7%‐100%).The positive predictive value for extralaryngeal spread on computed tomography for thyroid involvement was 100% (95% CI: 62.9%‐100%), and the negative predictive value was also 100% (95% CI: 93.5%‐100%).
Conclusions
This study has shown that preoperative computed tomography is an effective method of ruling out thyroid gland invasion. The absence of extralaryngeal spread on computed tomography has been shown to be the most useful finding, with a high negative predictive value and a narrow 95% CI.
Level of Evidence
4. Laryngoscope, 128:1099–1102, 2018</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Squamous Cell - diagnostic imaging</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>computed tomography scan</subject><subject>computerized axial tomography scan</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Histology</subject><subject>Humans</subject><subject>Laryngeal Neoplasms - diagnostic imaging</subject><subject>Laryngeal Neoplasms - surgery</subject><subject>Laryngectomy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness - diagnostic imaging</subject><subject>Neoplasm Invasiveness - pathology</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Squamous cell carcinoma</subject><subject>Thyroid gland</subject><subject>Thyroid Gland - diagnostic imaging</subject><subject>Thyroid Gland - pathology</subject><subject>thyroidectomy</subject><subject>Tomography, X-Ray Computed</subject><issn>0023-852X</issn><issn>1531-4995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM9LwzAcxYMobk4v_gFS8CJCZ340bXKSMdQJA0Em6ClkSbpV2mYmraP_vZmdHjx4-h7e5_t47wFwjuAYQYhvSum6MU45zg7AEFGC4oRzegiGQSQxo_h1AE68f4cQZYTCYzDAjDOWIDQEi5ndRs6UhVyWXaRkHSlbbdrG6KixlV05uVl30cYZXagmatads4WOivpT-sLWQSisC2S0y1CvjApP3e0pOMpl6c3Z_o7Ay_3dYjqL508Pj9PJPFaEZlmcQxXCSs05Z3yZY6mQSThCNEPEYJKnakkkSZFmiaZMhYZUM50xSikkqU7JCFz1vhtnP1rjG1EVXpmylLWxrReIJxyylEEe0Ms_6LttXR3SCQxxRjmkhAbquqeUs947k4tQsArVBIJit7XY9RTfWwf4Ym_ZLiujf9GfcQOAemBblKb7x0rMJ89vvekXiSuJag</recordid><startdate>201805</startdate><enddate>201805</enddate><creator>Harris, Andrew S.</creator><creator>Passant, Carl D.</creator><creator>Ingrams, Duncan R.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1853-0045</orcidid></search><sort><creationdate>201805</creationdate><title>How reliably can computed tomography predict thyroid invasion prior to laryngectomy?</title><author>Harris, Andrew S. ; Passant, Carl D. ; Ingrams, Duncan R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3577-f0c531ad99989bf2ac1e49115713e23f6cb3a361d84d58c2695d8d78555036d63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Squamous Cell - diagnostic imaging</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>computed tomography scan</topic><topic>computerized axial tomography scan</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Histology</topic><topic>Humans</topic><topic>Laryngeal Neoplasms - diagnostic imaging</topic><topic>Laryngeal Neoplasms - surgery</topic><topic>Laryngectomy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness - diagnostic imaging</topic><topic>Neoplasm Invasiveness - pathology</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Squamous cell carcinoma</topic><topic>Thyroid gland</topic><topic>Thyroid Gland - diagnostic imaging</topic><topic>Thyroid Gland - pathology</topic><topic>thyroidectomy</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Harris, Andrew S.</creatorcontrib><creatorcontrib>Passant, Carl D.</creatorcontrib><creatorcontrib>Ingrams, Duncan R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>The Laryngoscope</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Harris, Andrew S.</au><au>Passant, Carl D.</au><au>Ingrams, Duncan R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How reliably can computed tomography predict thyroid invasion prior to laryngectomy?</atitle><jtitle>The Laryngoscope</jtitle><addtitle>Laryngoscope</addtitle><date>2018-05</date><risdate>2018</risdate><volume>128</volume><issue>5</issue><spage>1099</spage><epage>1102</epage><pages>1099-1102</pages><issn>0023-852X</issn><eissn>1531-4995</eissn><abstract>Objectives/Hypothesis
There is little evidence to support the removal of thyroid tissue during total laryngectomy. Although oncological control of the tumor is the priority, thyroidectomy can lead to hypothyroidism and hypoparathyroidism. This study aimed to test the usefulness of preoperative computed tomography in predicting histological invasion of the thyroid.
Study Design
Ambispective cohort study.
Methods
All patients undergoing total laryngectomy for squamous cell carcinoma at one center from 2006 to 2016 were included. Data were recorded prospectively as part of the patients' standard care, but were collated retrospectively, giving this study an ambispective design. The histology report for thyroid invasion was taken as the gold standard. The computed tomography report was categorized by invasion of tumor into intralaryngeal, laryngeal cartilage involvement, and extralaryngeal tissues.
Results
Seventy‐nine patients were included. Nine patients had thyroid involvement on histology, translating to an incidence of 11.29% in this population. The positive predictive value for cartilage involvement on computed tomography for thyroid invasion was 52.9% (95% confidence interval [CI]: 28.5%‐76.1%) and the negative predictive value was 100% (95% CI: 92.7%‐100%).The positive predictive value for extralaryngeal spread on computed tomography for thyroid involvement was 100% (95% CI: 62.9%‐100%), and the negative predictive value was also 100% (95% CI: 93.5%‐100%).
Conclusions
This study has shown that preoperative computed tomography is an effective method of ruling out thyroid gland invasion. The absence of extralaryngeal spread on computed tomography has been shown to be the most useful finding, with a high negative predictive value and a narrow 95% CI.
Level of Evidence
4. Laryngoscope, 128:1099–1102, 2018</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>28988411</pmid><doi>10.1002/lary.26927</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0003-1853-0045</orcidid></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Carcinoma, Squamous Cell - diagnostic imaging Carcinoma, Squamous Cell - surgery computed tomography scan computerized axial tomography scan Female Health risk assessment Histology Humans Laryngeal Neoplasms - diagnostic imaging Laryngeal Neoplasms - surgery Laryngectomy Male Middle Aged Neoplasm Invasiveness - diagnostic imaging Neoplasm Invasiveness - pathology Predictive Value of Tests Prospective Studies Retrospective Studies Squamous cell carcinoma Thyroid gland Thyroid Gland - diagnostic imaging Thyroid Gland - pathology thyroidectomy Tomography, X-Ray Computed |
| title | How reliably can computed tomography predict thyroid invasion prior to laryngectomy? |
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