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Master Thesis

Evaluation de la corrélation radioclinique des tumeurs malignes de la fente olfactive

Abstract : Malignant tumors of the olfactory cleft (OC) are rare. Their prognostic is due to their local extension and to the surgical resecability. The pre-therapeutic tumor’s local extent seems to be over-evaluated by the radiologist (R) generating major avoidable iatrogenic morbidities, mainly intracranial. The goal of this study is to evaluate the radio-clinical correlation of the OC malignant tumors’ local extent. An observational, prospective, multicentered, multidisciplinary study was driven from July 2015 to July 2016 on intestinal type sinonasal adenocarcinoma and olfactory neuroblastoma of the OC. Pre-therapeutic (cT) and pathologic classifications (pT) were analyzed and compared; a qualitative analysis on 28 local anatomical structures and a quantitative analysis on an anatomical diagram filling were made independently by a specialized radiologist (R) based on preoperative imaging, a senior surgeon (S) based on endoscopic surgical procedure, and a senior pathologist (P). An equivalent of p<0,05 was considered significant and Cohen’s Kappa coefficient (κ) was calculated for each anatomical structure. 19 patients in 6 different centers were included in the analysis. The cT stages were significantly higher than the pT stages of the International Union against Cancer (UICC) classification (p=0,005). The global R-P correlation was mediocre (κ=0,35 [0,25-0,46]), and the global S-P correlation was good (κ=0,61 [0,50-0,71]). The R significantly overevaluated the local extent compared to the S (p<0,0045) and the P (p<0,0008) on the quantitive analysis. The R over-evaluates OC malignant tumors’ local extent qualitatively and quantitatively. A new adapted classification for these tumors is proposed.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01391457
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Submitted on : Thursday, November 3, 2016 - 12:50:18 PM
Last modification on : Wednesday, August 23, 2017 - 4:41:05 PM
Long-term archiving on: : Saturday, February 4, 2017 - 1:23:03 PM

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Sylvestre Fierens. Evaluation de la corrélation radioclinique des tumeurs malignes de la fente olfactive . Médecine humaine et pathologie. 2016. ⟨dumas-01391457⟩

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