Background: Review of laryngectomy specimens demonstrated that preoperative CT scanning is suboptimal in predicting both thyroid cartilage penetration and extralaryngeal spread. We investigated the association between the CT-based gross tumor volume (GTV) with pathologic evidence of thyroid cartilage penetration among patients undergoing laryngectomy for squamous cell carcinoma (SCC) of the larynx.
Methods: Ninety-four patients were identified who underwent total laryngectomy for SCC of the larynx. GTV, as defined by preoperative diagnostic CT scan, was contoured and analyzed using treatment-planning software.
Results: Among the 49 nonirradiated patients, the mean GTVs of patients with (n = 15) and without (n = 34) thyroid cartilage penetration was 60.1 and 28.0 cm(3) (p = .004). When the nonirradiated patients were divided into 3 GTV groups (≤25 cm(3), 25-50 cm(3), >50 cm(3)), the rates of thyroid cartilage penetration were 23%, 17%, and 78%, respectively (p = .003).
Conclusions: Laryngeal tumor volume is associated with pathologic evidence of thyroid cartilage penetration in nonirradiated patients.
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