Page 58 - Portuguese Journal - SPORL - Vol 61. Nº2

cartilage (p=0.039), and contralateral (p=0.022) the patients’ comorbidities and characteristics,
and extralaryngeal involvement (p=0.05), than as well as the tumor characteristics, and
for the invasion of the paraglottic space (only based on the guidelines of the National
eight in 19 cases) and thyroid cartilage (six in 18 Comprehensive Cancer Network, seven of
cases for the internal surface and 10 in 18 cases the 13 patients were found to be eligible for
for the external surface). A complementary organ-preserving treatment. Surgery was
magnetic resonance imagin g (MRI) study the proposed treatment for the remaining
was performed in five of the 19 patients. With patients (Table 4).
regard to the invasion of the thyroid cartilage, With regard to the cases in which there was
the findings of CT-MRI were only consistent a change in the N category, clinico-imaging
in two cases, increasing to four cases when and clinico-pathological correlation were
assessing the MRI/pathology agreement considered in the case of N0 or N+, and there
(Table 3). was a clinico-imaging correlation in 15/24 cases
Patients with T category upstaging did (62.5%), especially in those who underwent
not have narrow surgical margins (<5 mm) a PET scan (p=0.02). The change in the N
(p=0.575) or relapse (p=1.000) more frequently. classification was not related to the tumor size
Among the cases in which there was (p=0.093) or side of the lymph nodes (p=0.317).
downstaging of the T category, after assessing

Table 2
Differences between the clinical and pathological staging

Pathological T stage Pathological N stage
Clinical T stage T1 T2 T3 T4 Clinical N stage N0 N1 N2 N3
T1 - - - - N0 19 1 6 1
T2 1 1 - 1 N1 1 1 2 3
T3 2 3 19 5 N2 3 2 7 5

T4 - 1 6 15 N3 - - - 3
Downstage (n) 3 4 6 - Downstage (n) 4 2 - -
Upstage (n) - - - 6 Upstage (n) - 1 8 9

Table 3
Clinical-pathological agreement for different variables

Variable Clinico-pathological agreement p-value
Preepiglottic space 84,2% (16/19) 0,017
Paraglottic space 42,1% (8/19) 0,650
Anterior commissure 88,2% (15/17) 0,003

Posterior commissure 58,8% (10/17) 1,000
Subglottis 88,2% (15/17) 0,063
Internal surface of the thyroid cartilage 33,3% (6/18) 0,335
External surface of the thyroid cartilage 55,6% (10/18) 0,294
Cricoid cartilage 89,5% (17/19) 0,039
Arytenoid cartilages 66,7% (12/18) 0,326
Contralateral extension 83,3% (15/18) 0,022
Extralaryngeal extension 77,8% (14/18) 0,050

200 Portuguese Journal of Otorhinolaryngology - Head and Neck Surgery