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Clinical and Pathological Staging Discrepancies in Laryngeal Cancer: A Systematic Review
Giancarlo Pecorari1, Andrea Lorenzi1, Matteo Caria1
1Division of Otorhinolaryngology, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy.
Cancers
|February 13, 2025
Summary
Clinical staging for laryngeal cancer (LSCC) often mismatches pathological staging, impacting treatment. This review highlights significant inaccuracies, particularly understaging in T2 and T3 tumors, affecting patient outcomes.
Area of Science:
- Oncology
- Head and Neck Surgery
- Diagnostic Imaging
Background:
- Laryngeal squamous cell carcinoma (LSCC) is a common head and neck cancer.
- Accurate staging (clinical TNM vs. pathological TNM) is crucial for treatment decisions.
- Current imaging modalities show limitations in precisely determining LSCC extent.
Purpose of the Study:
- To systematically review and evaluate the concordance between clinical and pathological staging in LSCC.
- To quantify staging inaccuracies, including under- and overstaging.
- To identify implications for LSCC management and patient outcomes.
Main Methods:
- Comprehensive literature search across major biomedical databases (PubMed, Embase, Scopus, Cochrane, Web of Science).
- Inclusion of retrospective case series and observational studies with direct cTNM-pTNM correlation.
- Data extraction and analysis of concordance rates and staging discrepancies.
Main Results:
- Thirty-one studies involving 7939 patients were analyzed.
- Overall clinical-pathological staging concordance was 86.43%.
- Understaging was common in clinical T2 and T3 LSCC, while T4 showed higher concordance.
Conclusions:
- Clinical staging accuracy for LSCC remains a significant challenge.
- Imaging limitations in detecting subtle invasion lead to frequent staging errors.
- Inaccurate staging can negatively impact oncologic outcomes, especially for organ-preservation strategies.
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