Predictive Value of Laryngeal Cartilage Sclerosis on CT-Scan

Abstract

Objective: The value of laryngeal sclerosis as a sign of neoplastic invasion on CT-scan is controversial. We investigated the value of laryngeal cartilage sclerosis on CT-scan as a predictor of locoregional control, success of organ preservation, and survival for patients treated with radiation therapy for laryngeal carcinoma.

Method: Retrospective chart review on patients treated for laryngeal carcinoma with radiation therapy at the CHUM between 2002 and 2007. A head and neck radiologist revised each patient’s pretreatment CT-scan to determine the presence of laryngeal cartilage sclerosis. This variable was correlated with locoregional control, laryngectomy, and survival rates.

Results: Of the 111 patients, 76% were male and 24% female. Their mean age was 61 years. Forty-eight had supraglottic tumors and 63 had glottic tumors. Seven percent had thyroid cartilage sclerosis, 5% cricoid cartilage sclerosis, 55% arytenoid cartilage sclerosis, and 16% arytenoid cartilage sclerosis with adjacent tumor. There was no significant correlation demonstrated between cartilage sclerosis and locoregional control rate, laryngectomy rate and global and disease-free survival.

Conclusion: Cartilage sclerosis on CT-scan cannot be identified as a powerful predictor of treatment failure for patients with laryngeal carcinoma treated with radiation, which confirms our therapeutic attitude.