Value of pre- and intraoperative diagnostic methods in suspected glottic neoplasia
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Value of pre- and intraoperative diagnostic methods in suspected glottic neoplasia. / Mehlum, Camilla Slot; Kjaergaard, Thomas; Grøntved, Ågot Møller; Lyhne, Nina Munk; Jørkov, Andreas Peter Schjellerup; Homøe, Preben; Tvedskov, Jesper Filtenborg; Bork, Kristian Hveysel; Möller, Sören; Jørgensen, Gita; Philipsen, Bahareh Bakhshaie; Godballe, Christian.
In: European Archives of Oto-Rhino-Laryngology, Vol. 277, No. 1, 2020, p. 207-215.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Value of pre- and intraoperative diagnostic methods in suspected glottic neoplasia
AU - Mehlum, Camilla Slot
AU - Kjaergaard, Thomas
AU - Grøntved, Ågot Møller
AU - Lyhne, Nina Munk
AU - Jørkov, Andreas Peter Schjellerup
AU - Homøe, Preben
AU - Tvedskov, Jesper Filtenborg
AU - Bork, Kristian Hveysel
AU - Möller, Sören
AU - Jørgensen, Gita
AU - Philipsen, Bahareh Bakhshaie
AU - Godballe, Christian
N1 - Correction: https://doi.org/10.1007/s00405-020-06007-6
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
KW - Diagnostic accuracy
KW - Glottic
KW - Neoplasia
KW - Precursor lesion
KW - Premalignant
U2 - 10.1007/s00405-019-05698-w
DO - 10.1007/s00405-019-05698-w
M3 - Journal article
C2 - 31654182
AN - SCOPUS:85074611879
VL - 277
SP - 207
EP - 215
JO - Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde
JF - Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde
SN - 0942-8992
IS - 1
ER -
ID: 253148578