The importance of pre-epiglottis space invasion in the treatment planning of larynx and hypopharynx cancer.
The involvement of pre-epiglottis space can change the indication for partial laryngeal resection.


OBJECTIVE
The aim of this study was to evaluate inter-observer and intra-observer agreement by means of computed tomography analysis regarding the involvement of the pre-epiglottis space (PES) from carcinoma of the upper aerodigestive tract and its relation with therapeutic planning.


METHODS
Retrospective study of ninety-five computed tomography exams of patients with squamous cell carcinoma, from 1990 to 2004, were selected and evaluated; 87 were males and eight females, with ages ranging from 32 to 73 years. Imaging results were analyzed twice by three radiologists, individually, without any previous knowledge of the clinical stage. No patient had received any previous treatment up to the moment of imaging examination, such as surgery, chemotherapy or radiotherapy. All the cases were confirmed by biopsy. Information was obtained from the medical charts.


RESULTS
Kappa Index was calculated by assessing agreement between the three observers. We obtained substantial to almost perfect levels of agreement.


CONCLUSIONS
After a general Kappa Index of 0.72, the results suggest a substantial agreement in the involvement of the PES by means of computed tomography analysis.
Rapoport
Abrão
A
Dept Saúde, Hospital Heliópolis, SP, Brazil.
Botelho
Renato Assayag
RA
Souza
Ricardo Pires de
RP
Cavalcanti
Saulo Montenegro
SM
Furlam
Sérgio
S
Tornin
Olger de Souza
Ode S
Souza
Tânia Regina Bastos
TR
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology*; D004825:Epiglottis / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed