Systemic Imaging for Early Laryngeal Cancer: A Single-Centre Review of Guideline Application in Contemporary Clinical Practice.

OBJECTIVE

National Institute for Health and Care Excellence (NICE) no longer recommends offering systemic staging for early laryngeal cancer (T1N0 and T2N0). We aim to evaluate (1) whether guidance is being followed in our centre, (2) assess the impact on our patients and (3) perform a cost analysis.

METHODS

We retrospectively reviewed all laryngeal cases at a major Head and Neck cancer centre between January 01, 2020, and January 01, 2025. The following information was collected for all the patients: neck/systemic imaging modalities performed on patients, demographics, site of original laryngeal tumour and any metastatic disease detected by systemic imaging. We performed a cost analysis based on methods undertaken by NICE.

RESULTS

n = 83 patients had laryngeal cancer, n = 30 had T1N0 and T2N0 disease. Systemic imaging found no metastatic disease, n = 2 primary tumours and n = 1 lung infection. Systemic imaging cost £4207.12 and neck imaging cost £12 335.07.

CONCLUSIONS

NICE guidance is not being followed at our centre, with limited benefits.