Evaluation of treatment results with regard to initial anterior commissure involvement in early glottic carcinoma treated by external partial surgery or transoral laser microresection

Head & Neck ◽  
2009 ◽  
Vol 31 (4) ◽  
pp. 531-537 ◽  
Author(s):  
Florian Sachse ◽  
Wolfgang Stoll ◽  
Claudia Rudack
Keyword(s):  
Anterior Commissure ◽  
Glottic Carcinoma ◽  
Treatment Results ◽  
Early Glottic Carcinoma

Prognostic Factors in Early Glottic Carcinoma Implications for Treatment

2005 ◽  
Vol 91 (2) ◽  
pp. 182-187 ◽  
Author(s):  
Demiral Ayse Nur ◽  
Cetinayak Oguz ◽  
Erdag Taner Kemal ◽  
Eyiler Ferhat ◽  
Sarıoglu Sülen ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Treatment Time ◽  
Salvage Surgery ◽  
Anterior Commissure ◽  
The Other ◽  
Second Primary ◽  
Partial Laryngectomy ◽  
Glottic Carcinoma ◽  
T Classification ◽  
Early Glottic Carcinoma

Aim In this study we aimed to determine the prognostic factors affecting local control (LC) in limited glottic carcinoma treated with definitive radiotherapy (RT). Material and methods Between June 1991 and December 2001, 114 patients with early squamous-cell carcinoma of the glottis were treated with definitive RT at our institution. Only four (3.5%) patients were women. The median age was 60 (27-79). Fifteen percent, 72% and 13% of the patients had Tis, T1 and T2 tumors, respectively. Forty-three (37.7%) patients had anterior commissure invasion. Prior to RT 35 (31%) patients had undergone vocal cord stripping and two (2%) cordectomy. A median dose of 66 Gy (50-70.2) was given over a median period of 46 days (20-60). Univariate and multivariate analyses were performed for LC. The prognostic parameters analyzed for LC were T classification, anterior commissure involvement, total RT dose, and overall treatment time. Results Five-year local and regional control rates were 84.2% and 97.7%. RTOG grade 3-4 late side effects were observed only in one (0.9%) patient. In 15 patients with local failure, salvage treatment consisted of partial laryngectomy in eight patients and total laryngectomy in five. One of the remaining two patients was medically inoperable, and the other refused salvage surgery. In one of the three patients with regional failure, salvage surgery was applied and the other two were given palliative chemotherapy because of unresectable disease. Following salvage treatments, the ultimate five-year LC rate was 96.9% and the five-year larynx preservation rate was 91.1%. Second primary cancer was diagnosed in 17 (14.9%) patients. Only one patient developed distant metastases and two patients died of laryngeal cancer. While T2 disease and anterior commissure involvement were found to be unfavorable prognostic factors significantly influencing LC in univariate analyses, only T2 disease remained independent in multivariate analysis. Conclusion In patients with early glottic carcinoma, T classification proved to be the only independent prognostic factor affecting LC after primary radiotherapy according to the results of this study.

Early glottic carcinoma involving the anterior commissure

1994 ◽  
Vol 19 (2) ◽  
pp. 105-108 ◽  
Author(s):  
J. SHVERO ◽  
T. HADAR ◽  
K. SEGAL ◽  
R. LEVY ◽  
R. FEINMESSER
Keyword(s):  
Anterior Commissure ◽  
Glottic Carcinoma ◽  
Early Glottic Carcinoma

Impact of Anterior Commissure Involvement on Local Control of Early Glottic Carcinoma Treated by Laser Microresection

2004 ◽  
Vol 114 (8) ◽  
pp. 1485-1491 ◽  
Author(s):  
Wolfgang Steiner ◽  
Petra Ambrosch ◽  
Ralph M.W. R??del ◽  
Martina Kron
Keyword(s):  
Local Control ◽  
Anterior Commissure ◽  
Glottic Carcinoma ◽  
Early Glottic Carcinoma

Transoral robotic surgery for early glottic carcinoma involving anterior commissure: Preliminary reports

Head & Neck ◽  
2015 ◽  
Vol 38 (6) ◽  
pp. 913-918 ◽  
Author(s):  
Chen-Chi Wang ◽  
Shih-An Liu ◽  
Shang-Heng Wu ◽  
Wen-Jiun Lin ◽  
Rong-San Jiang ◽  
...  
Keyword(s):  
Robotic Surgery ◽  
Anterior Commissure ◽  
Transoral Robotic Surgery ◽  
Glottic Carcinoma ◽  
Early Glottic Carcinoma

Evaluation of voice and quality of life after transoral endoscopic laser resection of early glottic carcinoma

2011 ◽  
Vol 125 (7) ◽  
pp. 706-713 ◽  
Author(s):  
Y Bajaj ◽  
S Uppal ◽  
R K Sharma ◽  
A R H Grace ◽  
D M Howard ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Anterior Commissure ◽  
Glottic Carcinoma ◽  
Life Questionnaire ◽  
Symptom Scale ◽  
Laryngeal Function ◽  
Vocal Function ◽  
Laser Resection ◽  
Early Glottic Carcinoma

AbstractObjective:This study aimed to evaluate voice and quality of life after transoral laser resection of early glottic carcinoma.Methods:We studied 19 patients undergoing transoral laser resection of tumour stage (T) one or T2 glottic carcinoma. Laryngeal function was evaluated by video-stroboscopy, vocal function by the Voice Symptom Scale, the grade-roughness-breathiness-asthenia-strain scale and objective phoniatric assessment, and quality of life by the University of Washington Quality of Life questionnaire.Results:Patients’ glottic carcinoma tumour-node-metastasis (TNM) staging was T1 N0 M0 in 14 patients and T2 N0 M0 in five. Overall voice grade, roughness and breathiness were mild to moderate in 84 per cent; asthenia and voice strain were more uniformly distributed, with 15 per cent of patients having normal voice quality. Eight patients developed a glottic web post-operatively; anterior commissure web was significantly associated with worse voice grade (p = 0.05). Seven patients (47 per cent) had a ‘mucosal wave’ on the operated vocal fold; this was significantly associated with less strain on phonation (p = 0.05). Voice Symptom Scale score was low overall (15 patients (78.9 per cent) scored less than 30). The fundamental frequency and frequency irregularity were normal in nine patients (47.3 per cent); the closed quotient was normal in six (31.5 per cent). The averaged quality of life score was ≥90 in 14 patients (73.7 per cent); 18 (94.7 per cent) felt their health-related quality of life was either the same or better post-operatively; and overall quality of life was positive in all.Conclusion:Transoral laser resection of T1 and T2 glottic carcinoma enables adequate tumour tissue excision with preservation of acceptable vocal function. Most patients’ post-operative quality of life is very good. Anterior commissure web formation is associated with poorer vocal function.

scholarly journals T1 Glottic Cancer: Does Anterior Commissure Involvement Worsen Prognosis?

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1485
Author(s):  
Giuditta Mannelli ◽  
Lara Valentina Comini ◽  
Roberto Santoro ◽  
Alessandra Bettiol ◽  
Alfredo Vannacci ◽  
...  
Keyword(s):  
Anterior Commissure ◽  
Tumor Location ◽  
Treatment Modalities ◽  
Glottic Cancer ◽  
Glottic Carcinoma ◽  
Free Survival ◽  
Increased Risk ◽  
Early Glottic Carcinoma

Radiotherapy (RT) and transoral laser microsurgery (TLM) represent the main treatment modalities for early glottic carcinoma. Local failure is notoriously more frequent in T1b glottic cancer in comparison to T1a and T2 tumors. In this scenario, the role of anterior commissure (AC) involvement is still controversial. The aim of the present study was therefore to determine its potential prognostic power in worsening patients’ survival and outcomes. We categorized different tumor glottic fold locations with respect to the involvement of one (T1a) or both vocal cords, with or without AC involvement. We analyzed a retrospective cohort of 74 patients affected by Stage I glottic cancer, treated between 2011 and 2018 by TLM or RT at a single academic institution. There were 22 T1a (30%) and 52 T1b (70%) cases. The median follow-up period was 30 months (mean, 32.09 ± 18.738 months; range, 12–79). Three-year overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and laryngectomy-free survival (LFS) were compared according to tumor location, extension, and cT category. According to both uni- and multivariate analyses, an increased risk for recurrence in T1b with AC involvement and T1a tumors was 7.31 and 9.45 times, respectively (p-values of 0.054 and 0.030, respectively). Among the 17 recurrences, T1b with AC involvement experienced 15 tumor relapses (88.2%), thus significantly affecting both the RFS and LFS in comparison to the other two tumor subcategories (T1a, p = 0.028 and T1b without AC involvement, p = 0.043). The deteriorating prognosis in the presence of AC involvement likely reflects the need to power the hazard consistency and discrimination of the T1b category when associated with such a risk factor, thus deserving an independent T category.

Sign in / Sign up

Export Citation Format

Share Document