Background: National Institute for Health and Care Excellence (NICE) guidelines were updated in 2016 and recommended to no longer offer systemic staging for early laryngeal cancer. Our study aims to evaluate (1) if NICE guidance on the role of systemic imaging in the assessment and management of early laryngeal cancer is being followed in our centre (2) assess the impact of this practice on our patients (3) perform a cost analysis relevant to our institution.
Methods: We retrospectively reviewed all laryngeal cases at a major H&N cancer centre between 01/01/2020 and 01/01/2022. The following information was collected for all the patients: tumour stage, neck/systemic imaging modalities performed on patients, demographics, site of laryngeal tumour and any metastatic disease detected by systemic imaging. We performed a cost analysis based on the cost analysis method undertaken by NICE.
Results: Our results showed n=83 patients had laryngeal cancer between 01/01/2020 and 01/01/2022. Of which n=30 had early disease. Systemic imaging found no metastatic disease, n=2 primary lung tumours and n=1 lung infection. The total cost for systemic and neck imaging was £4,207.12, £12,335.07 respectively.
Conclusion: Our study concludes NICE guidance is not being followed at our centre. The practice of systemic imaging has little benefit to patients.