Staging of Laryngeal Cancer: Clinicoradiological versus Histopathological Findings using Modified Laryngeal Sectioning

Abstract

INTRODUCTION: Laryngeal cancer is commonly encountered in India. Post operative whole organ sectioning of the larynx, although informative, can often be tedious and cumbersome. This study aims to define a modified method of laryngeal sectioning and to assess its level of agreement with pre-operative clinicoradiological findings with regard to T-stage of laryngeal cancer.
 METHODOLOGY: Prospective study was conducted on 15 patients diagnosed with laryngeal carcinoma, who underwent total laryngectomy with neck dissection. The pre-operative clinicoradiological T-stage, was compared to the post-operative pathological T-stage, obtained after histopathological examination of sections taken from relevant areas of the total laryngectomy specimen using modified laryngeal sectioning.
 RESULTS: When compared to the pathological staging obtained after modified laryngeal sectioning, clinical T-staging over-staged the tumour in 3 cases and under-staged the tumour in 2 cases, and was similar in the remaining 10 cases. The level of agreement in determining the T-stage was ‘fair’.
 CONCLUSION: The T-stages determined by pre-operative clinicoradiological findings and post-operative histopathological findings after modified laryngeal sectioning, were similar in two-third cases. While whole organ laryngeal sectioning remains the gold standard, it is often a costly and cumbersome process. We propose the use of representative tissue samples from the areas of interest for histopathological examination, obtained by sectioning the larynx at relevant points only, as it saves time and is less resource intensive.