Improved Diagnostic Accuracy in the TNM Staging of Laryngeal Cancer Using a New Definition of Regions Based on Computed Tomography

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Abstract
Neither laryngoscopy nor laryngography can match the accuracy with which computed tomography (CT) can display the full tumor extent or the presence of cartilage invasion. Data obtained from a CT-histologic correlative study have suggested a new definition of regions of the larynx for use with the TNM staging of laryngeal cancer. The arytenoid cartilage, readily identifiable by CT, is used for reference. The regions are as follows: (a) supra-arytenoid, (b) midarytenoid, (c) vocal process, and (d) infra-arytenoid. Tumors with a strong propensity for cartilage invasion can be distinguished from those without this tendency. In addition, tumors with different pathways of lymphatic drainage can be identified.