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Radiological tumor thickness as a risk factor for local recurrence in early glottic cancer treated with laser cordectomy

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objectives

Despite the excellent prognosis of early glottic cancer (T1–T2), the significance of preoperatively measured tumor thickness has not been elucidated. We evaluated the role of tumor thickness measured using computed tomography (CT) as a predictive factor for recurrence of early glottic cancer after transoral laser microsurgery (TLM).

Methods

The medical records of 134 patients who were diagnosed with early glottic squamous cell carcinoma and underwent TLM were reviewed. Age, sex, clinical stage, preoperative biopsy, anterior commissure involvement, CT findings, recurrence, and overall survival were evaluated.

Results

Seventy-three patients (54 T1a, 2 T1b, and 17 T2) were enrolled. Tumor thickness on pathology increased proportionally with increased tumor thickness on CT. The recurrence-free survival (RFS) and overall survival rates were 82.2 and 91.2%, respectively. Upon univariate analysis, RFS was affected by the type of cordectomy, tumor differentiation, margin involvement, anterior commissure involvement, impaired vocal fold mobility, and tumor thickness (> 4 mm) on CT scan (all p < 0.01). Among the relevant covariates, an involved or close resection margin [hazard ratio (HR) 19.2; 95% confidence interval (CI) 3.5–105.6; p < 0.01], impaired vocal cord mobility (HR 8.5; 95% CI 1.45–49.2; p = 0.02), and pathological tumor thickness (> 4 mm) (HR 6.0; p = 0.02) were predictive of RFS.

Conclusion

Tumor thickness may be another predictive factor for recurrence in early glottic cancer. Before TLM, reviewing the extent of tumor thickness will help to improve local control in cases of early glottic cancer.

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Acknowledgements

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIP) (2016-0499; awarded to YSL). These funding sources had no involvement in the collection, analysis, or interpretation of the data, the writing of the report, or the decision to submit the article for publication.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Daegu Catholic University College of Medicine, Daegu, Republic of Korea

    Ho-Jin Son

  2. Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Yoon Se Lee, Ja Yoon Ku, Jong-Lyel Roh, Seung-Ho Choi, Soon Yuhl Nam & Sang Yoon Kim

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  1. Ho-Jin Son
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  2. Yoon Se Lee
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Correspondence to Yoon Se Lee.

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Funding

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIP) (2016-0499; awarded to YSL). These funding sources had no involvement in the collection, analysis, or interpretation of the data, the writing of the report, or the decision to submit the article for publication.

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were done so in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Son, HJ., Lee, Y.S., Ku, J.Y. et al. Radiological tumor thickness as a risk factor for local recurrence in early glottic cancer treated with laser cordectomy. Eur Arch Otorhinolaryngol 275, 153–160 (2018). https://doi.org/10.1007/s00405-017-4793-3

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  • DOI: https://doi.org/10.1007/s00405-017-4793-3

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