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Primary treatment of the anterior vocal commissure squamous carcinoma

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Abstract

Squamous cell carcinoma may involve the anterior commissure (AC) area of the laryngeal glottis, and can be grouped morphologically into four groups; (1) tumor confined to the AC, (2) tumor involving one cord and the AC, (3) tumor involving the AC and a portion of both vocal cords, and (4) tumor involving a greater part of one cord and crossing over to involve a variable length of the other cord. Some of these patients when evaluated by imaging, either CT and/or MRI, may demonstrate thyroid cartilage erosion or involvement, thereby upstaging a T1a, T1b into a T3 or a T4 glottic cancer. The majority of patients treated by radiotherapy have only been staged clinically, and hence a failure or recurrence rate of 15%. In patients treated surgically by endoscopic or external surgery, the local recurrence rates are similar at 15%. Therefore, future reporting of patients treated with AC involvement should be staged radiologically, to include CT or MRI, and documentation of the treatment results be reported in subgroups, according to whether there is no cartilage involvement, inner-table cartilage erosion, or through-and-through cartilage invasion. Should endoscopic cordectomy be used, then the type of surgery performed should be based on the classification as suggested by the European Laryngological Society. The use of the above recommendations would allow for more meaningful results to be reported and for cause specific analysis of failure of treatment techniques applied.

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Authors and Affiliations

  1. Department of Otorhinolaryngology—Head and Neck Surgery, Queens Medical Centre, Nottingham, UK

    Patrick J. Bradley

  2. Department of Surgical Sciences, ENT Clinic, University of Udine, Policlinico Universitario, Piazzale S. Maria della Misericordia, 33100, Udine, Italy

    Alessandra Rinaldo & Alfio Ferlito

  3. Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain

    Carlos Suárez

  4. Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain

    Carlos Suárez

  5. Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

    Ashok R. Shaha & Snehal G. Patel

  6. Department of Otolaryngology—Head and Neck Surgery, VU University Medical Center, Amsterdam, The Netherlands

    C. René Leemans

  7. Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Johannes A. Langendijk

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  1. Patrick J. Bradley
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  2. Alessandra Rinaldo
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  4. Ashok R. Shaha
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  7. Snehal G. Patel
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  8. Alfio Ferlito
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Correspondence to Alfio Ferlito.

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Bradley, P.J., Rinaldo, A., Suárez, C. et al. Primary treatment of the anterior vocal commissure squamous carcinoma. Eur Arch Otorhinolaryngol 263, 879–888 (2006). https://doi.org/10.1007/s00405-006-0138-3

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  • DOI: https://doi.org/10.1007/s00405-006-0138-3

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