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Transoral laser resection of glottic carcinoma: what is the significance of anterior commissure involvement?

Published online by Cambridge University Press:  10 January 2017

K A Stephenson  and
J J Fagan
K A Stephenson
Affiliation:
Division of Otolaryngology, Great Ormond Street Hospital, London, UK
J J Fagan*
Affiliation:
Division of Otolaryngology, University of Cape Town, South Africa
*
Address for correspondence: Prof J J Fagan, Division of Otolaryngology, University of Cape Town, Cape Town, South Africa E-mail: [email protected]
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Abstract

Background:

The optimal management of glottic carcinoma involving the anterior commissure is controversial.

Method:

A retrospective analysis was conducted of 76 patients with glottic squamous cell carcinoma treated by transoral carbon dioxide laser resection by a single surgeon.

Results:

Sixty-three patients (with tumour stage Tis–T3) were eligible for inclusion. Thirty patients had involvement of the anterior commissure; these patients were significantly more likely to have either uncertain or positive margins (63.3 vs 30.3 per cent, p = 0.012), and were also more likely to receive adjuvant radiotherapy (40 vs 3.2 per cent, p = 0.0005). The overall laryngeal preservation rate was 96.8 per cent; there was no statistically significant difference between those with and without anterior commissure involvement (96.7 and 96.9 per cent respectively).

Conclusion:

Transoral laser resection with the use of adjuvant radiotherapy in a minority of patients with adverse pathological findings can be recommended for the primary treatment of anterior commissure glottic cancer from an oncological perspective; excellent local control and laryngeal preservation rates can be achieved.

Keywords

Laryngeal CancerAnterior Laryngeal CommissureLarynxLaserRadiotherapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 2 , February 2017 , pp. 168 - 172
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented at the 50th Congress of the South African Society of Otorhinolaryngology, Head and Neck Surgery, 18–21 October 2014, Cape Town, South Africa.

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