ABSTRACT NUMBER: (NESTAC_04)
Faculty of Medical Sciences, Newcastle University1
ENT Department, Freeman Hospital2
MAIN ABSTRACT TEXT
The National Institute for Health and Care Excellence (NICE) states that CT thorax is not required in patients with primary T1/T2 laryngeal cancer. Smoking is a risk factor for both laryngeal and bronchial carcinomas. Freeman Hospital currently requests CT thorax in addition to CT neck in all head & neck cancer patients.
1. To assess rates of significant CT thorax findings in patients with primary T1/T2 laryngeal cancer & the need to continue chest imaging. 2. To assess correlation between smoking & rates of significant CT thorax findings in this cohort.
A retrospective audit was done on 693 patients with head & neck cancers at the Freeman Hospital ENT Department. Target criteria included patients with primary T1/T2 squamous cell carcinoma in the vocal cords, epiglottis, aryepiglottic fold and subglottis, diagnosed from January 2016 to August 2018.
51 patients met target criteria. 42 were smokers/ ex-smokers, 6 were non- smokers, and 3 did not have smoking status documented. 4 patients (7.8%) had significant lung lesions on CT thorax. All of them were smokers. 3 patients had primary bronchogenic tumours ranging from 22-30mm. 1 patient had multifocal nodularities throughout both lungs due to metastases from a primary glottic tumour.
CT thorax should be requested in smokers/ ex-smokers with primary T1/T2 laryngeal cancer. Repeat audit on a larger cohort, analysing smokers versus non-smokers separately to assess if guidelines should be different for each group.