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

Camilla Slot Mehlum*, Thomas Kjaergaard, Ågot Møller Grøntved, Nina Munk Lyhne, Andreas Peter Schjellerup Jørkov, Preben Homøe, Jesper Filtenborg Tvedskov, Kristian Hveysel Bork, Sören Möller, Gita Jørgensen, Bahareh Bakhshaie Philipsen, Christian Godballe

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

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
ISSN0937-4477
DOI
StatusE-pub ahead of print - 25. okt. 2019

Fingeraftryk

Neoplasms
Logistic Models
Papilloma
Routine Diagnostic Tests
Cohort Studies
Prospective Studies
Confidence Intervals

Citer dette

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. / Value of pre- and intraoperative diagnostic methods in suspected glottic neoplasia. I: European Archives of Oto-Rhino-Laryngology. 2019.
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title = "Value of pre- and intraoperative diagnostic methods in suspected glottic neoplasia",
abstract = "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.",
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month = "10",
day = "25",
doi = "10.1007/s00405-019-05698-w",
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journal = "European Archives of Oto-Rhino-Laryngology",
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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.

I: European Archives of Oto-Rhino-Laryngology, 25.10.2019.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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

PY - 2019/10/25

Y1 - 2019/10/25

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

JO - European Archives of Oto-Rhino-Laryngology

JF - European Archives of Oto-Rhino-Laryngology

SN - 0937-4477

ER -