Diagnosis and staging of laryngopharyngeal tumours with flexible endoscopy: A prospective study

SA Journal of Oncology

Field Value
Title Diagnosis and staging of laryngopharyngeal tumours with flexible endoscopy: A prospective study
Creator Uys, Hendrik K. Pelser, Andrew Attwood, Rory Adam, Shaun Afrogheh, Amir Hille, Jos Loock, James W.
Subject otolaryngology; head and neck cancer office-based procedure; flexible endoscopy; biopsy; staging; larynx; pharynx
Description Background: Many suspected laryngopharyngeal neoplasms are examination under general anaesthesia (EUA). Office-based endoscopy is already routinely performed on all patients presenting with a suspected laryngopharyngeal neoplasm. Accurate clinical staging and tissue sampling using flexible endoscopy may eliminate the need for EUA.Aim: To compare the use of flexible endoscopy to EUA as primary diagnostic tool of laryngopharyngeal lesions to EUA, using accuracy of tissue samples obtained and clinical staging as primary outcome measures. Duration, patient tolerance and cost implications were also assessed.Setting: The study was performed in the outpatient department and surgical theatres of Tygerberg Hospital, Cape Town, South Africa.Methods: A prospective study compared staging and tissue sampling accuracy with flexible endoscopy to EUA in 54 patients. Duration, tolerance and cost implications were also assessed.Results: Flexible endoscopic biopsy had a 77.1% sensitivity, 100% specificity and 82.2% diagnostic accuracy. Liquid-based cytology had 97.3% sensitivity, 100% specificity and 97.9% diagnostic accuracy in differentiating high-grade lesions from low-grade lesions. Local staging agreement occurred in 88.6% (n = 31/35) of malignant cases. The mean duration was 15 ± 7 min; 86% of patients perceived the procedure as tolerable. Flexible endoscopy as a primary diagnostic tool would have avoided EUA in 68.6% (n = 24/35) of squamous cell carcinoma cases, with a R128 232 cost savings.Conclusion: Office-based endoscopy is an accurate, well-tolerated, time- and cost-effective primary diagnostic tool of laryngopharyngeal lesions. It reduces the number of patients requiring EUA. Further evaluation is empirical when the histopathology does not confirm the clinical suspicion of malignancy.
Publisher AOSIS
Contributor None
Date 2019-04-24
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Prospective
Format text/html application/epub+zip application/xml application/pdf
Identifier 10.4102/sajo.v3i0.56
Source South African Journal of Oncology; Vol 3 (2019); 8 pages 2523-0646 2518-8704
Language eng
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://sajo.org.za/index.php/sajo/article/view/56/191 https://sajo.org.za/index.php/sajo/article/view/56/190 https://sajo.org.za/index.php/sajo/article/view/56/192 https://sajo.org.za/index.php/sajo/article/view/56/189
Coverage Africa; South Africa; Western Cape; Boland region; Cape Winelands district August 2011 - November 2012 —
Rights Copyright (c) 2019 Hendrik Kendal Uys, Andrew Pelser, Rory Attwood, Shaun Adam, Amir Afrogheh, Jos Hille, James William Loock https://creativecommons.org/licenses/by/4.0