Value of pre- and intraoperative diagnostic methods in suspected glottic neoplasia

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DOI

  • Camilla Slot Mehlum, Odense University Hospital
  • ,
  • Thomas Kjaergaard
  • Ågot Møller Grøntved, Odense University Hospital
  • ,
  • Nina Munk Lyhne
  • Andreas Peter Schjellerup Jørkov, Københavns Universitet
  • ,
  • Preben Homøe, Københavns Universitet
  • ,
  • Jesper Filtenborg Tvedskov, Rigshospitalet
  • ,
  • Kristian Hveysel Bork, Rigshospitalet
  • ,
  • Sören Möller, Syddansk Universitet, Odense University Hospital
  • ,
  • Gita Jørgensen, Odense University Hospital
  • ,
  • Bahareh Bakhshaie Philipsen, Odense University Hospital
  • ,
  • Christian Godballe, Odense University Hospital

Abstract: To evaluate the individual and combined ability of videostroboscopy (VS), high-speed digital imaging (HSDI), enhanced endoscopy (EE) and saline infusion (SI) to predict neoplasia, defined as glottic precursor lesion (GPL) or T1a glottic cancer, in patients suspected for glottic neoplasia. Methods: A nationwide prospective cohort study of patients treated by cordectomy for suspected GPL or T1a glottic cancer from August 1st 2016 to October 31st 2018 was conducted in the five Danish University Departments of Head and Neck surgery. Sensitivity, specificity, negative and positive predictive values, and area under Receiver Operating Curves (AUC-ROC) were calculated with 95% confidence intervals with respect to the histological diagnosis. Logistic regression with an imputation model for missing data was applied. Results: 261 patients aged 34–91 years participated; 79 (30.3%) with non-neoplasia (i.e., inflammation, papilloma, hyperkeratosis) and 182 (69.7%) neoplasia, hereof 95 (36.4%) with GPL and 87 (33.3%) with T1a glottic cancer. Data from 188 VS, 60 HSDI, 100 preoperative EE, 209 intraoperative EE, and 234 SI were analyzed. In the complete case analysis the AUC-ROC of each diagnostic test was low, but increased when the tests were combined and especially if the combination included EE. However, multinomial logistic regression with imputation showed significant association (p < 0.05) only between age, male gender, and perpendicular vasculature in intraoperative EE, and the endpoint neoplasia. Conclusions: Intraoperative EE was the most accurate diagnostic method in detecting neoplasia. The prediction ability of methods applied preoperatively was more limited, but improved when test modalities were combined.

OriginalsprogEngelsk
TidsskriftEuropean Archives of Oto-Rhino-Laryngology
Vol/bind277
Nummer1
Sider (fra-til)207-215
Antal sider9
ISSN0937-4477
DOI
StatusUdgivet - jan. 2020

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