Abstract
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 ¼ 15) and without (n ¼ 34) thyroid cartilage penetration was 60.1 and 28.0 cm 3 (p ¼ .004). When the nonirradiated patients were divided into 3 GTV groups (� 25 cm 3 ,2 5-50 cm 3 , >50 cm 3 ), the rates of thyroid cartilage penetration were 23%, 17%, and 78%, respectively (p ¼ .003). Conclusions. Laryngeal tumor volume is associated with pathologic evidence of thyroid cartilage penetration in nonirradiated patients. V C 2012 Wiley Periodicals, Inc. Head Neck 35: 426-430, 2013
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