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Contact endoscopy for detection of residual or recurrent disease after radiotherapy for squamous cell carcinoma of the upper aerodigestive tract

Published online by Cambridge University Press:  02 April 2020

S Kumar ,
A K Mishra ,
J R Galagali ,
A Sethi  and
A Malik
S Kumar
Affiliation:
Department of Otorhinolaryngology – Head Neck Surgery, Army College of Medical Sciences and Base Hospital, Delhi Cantt, India
A K Mishra*
Affiliation:
Department of Otorhinolaryngology – Head Neck Surgery, Army College of Medical Sciences and Base Hospital, Delhi Cantt, India
J R Galagali
Affiliation:
Department of Otorhinolaryngology – Head Neck Surgery, Army College of Medical Sciences and Base Hospital, Delhi Cantt, India
A Sethi
Affiliation:
Department of Otorhinolaryngology – Head Neck Surgery, Army College of Medical Sciences and Base Hospital, Delhi Cantt, India
A Malik
Affiliation:
Department of Pathology and Laboratory Sciences, Army College of Medical Sciences and Base Hospital, Delhi Cantt, India
*
Author for correspondence: Professor Awadhesh Kumar Mishra, Department of Otorhinolaryngology – Head Neck Surgery, Army College of Medical Sciences and Base Hospital, Delhi Cantt110010, India E-mail: buddhiprakash@rediffmail.com Fax: +91 11 25698691
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Abstract

Objective

The aim of this study was to evaluate contact endoscopy in detecting local treatment failures post-radiotherapy in squamous cell carcinoma of the upper aerodigestive tract.

Method

A total of 135 consecutive patients with suspected residual or recurrent cancer after definitive radiotherapy underwent contact endoscopy before biopsy. Contact endoscopy findings were compared with histopathological examination findings. Contact endoscopy could not be completed in 7 patients (5.9 per cent) and histopathological examination was inconclusive in 5 patients (3.7 per cent). The findings of the remaining 123 patients were compared.

Results

The sensitivity, specificity and accuracy of contact endoscopy were 88.75, 88.72 and 86.99 per cent, respectively, with similar results across various sites of upper aerodigestive tract. Inter-observer kappa value was 0.86 (95 per cent confidence interval: 0.79–0.93). The intra-observer kappa value was 0.93 (95 per cent confidence interval: 0.87–1.00) for the first observer and 0.95 (95 per cent confidence interval: 0.90–1.00) for second and third observers.

Conclusion

Contact endoscopy showed the same high sensitivity and specificity with low inter- and intra-observer variability in detecting post-radiotherapy failures in cancer of the upper aerodigestive tract as has been shown in non-irradiated tissues in earlier studies.

Keywords

EndoscopyTreatment FailureCarcinomaSquamous CellObserver Variation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 4 , April 2020 , pp. 344 - 349
Copyright
Copyright © JLO (1984) Limited, 2020

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Footnotes

Professor A K Mishra takes responsibility for the integrity of the content of the paper

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