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T3 Glottic Carcinoma Revisited: Transglottic vs Pure Glottic Carcinoma

T3 Glottic Carcinoma Revisited: Transglottic vs Pure Glottic Carcinoma Abstract Objective: To compare results of treatment of patients who have T3 transglottic carcinoma with patients who have T3 pure glottic carcinoma. Design: A retrospective cohort study from January 1976 to December 1990 with a minimum 2-year follow-up. Setting: Eye and Ear Hospital, University of Pittsburgh Medical Center. Patients: The medical records of 161 patients with T3 glottic carcinoma were reviewed. We excluded 17 patients who were unavailable for follow-up or who had died of other causes but were free of glottic carcinoma. Therefore, 144 patients were entered into this study—79 patients with transglottic carcinoma and 65 with pure glottic carcinoma. Intervention: Three treatment groups consisted of the following: 30 patients in whom a full course of radiation therapy failed and who subsequently underwent salvage surgery; 92 patients who underwent surgery only; and 22 patients who underwent surgery and had postoperative radiation therapy. Seventy-five patients had total laryngectomy, and 69 had total laryngectomy with neck dissection. Main Outcome Measures: Cervical metastasis, extracapsular spread, local failure, stomal recurrence, distant metastasis, and 2 years with no evidence of disease. Results: Patients with T3 transglottic carcinoma had a higher incidence of occult cervical metastasis (12% vs 9%), overall cervical metastasis (27% vs 17%), and extracapsular spread (43% vs 27%) than did patients with T3 pure glottic carcinoma. Two years of no disease was similar in these two groups (80% vs 79%). Extracapsular spread had a notable effect on distant metastasis and on 2 years of no disease. Conclusion: Patients with T3 transglottic carcinoma had a higher incidence of cervical metastasis and extracapsular spread than patients with T3 pure glottic carcinoma. Every patient with T3 transglottic carcinoma should be treated with total laryngectomy with neck dissection.(Arch Otolaryngol Head Neck Surg 1995;121:166-170) References 1. McGavran MH, Bauer WC, Ogura JH. The incidence of cervical lymph node metastasis from epidermoid carcinoma of the larynx and their relationship to certain characteristics of the primary tumor . Cancer . 1961;14:55-66.Crossref 2. Beckford NS, Myers EN. The role of total laryngectomy in the treatment of carcinoma . In: Myers EN, ed. New Dimension in Otorhinolaryngology—Head and Neck Surgery . New York, NY: Elsevier Science Publishing Co Inc; 1985:390-393. 3. American Joint Committee on Cancer. Manual for Staging of Cancer . 4th rev ed. Philadelphia, Pa: JB Lippincott; 1992:39-41. 4. UICC International Union Against Cancer . TNM: Classification of Malignant Tumors . 4th rev ed. New York, NY: Springer-Verlag Co; 1987:23-26. 5. LeRoux-Robert J. Les Epitheliomes Intra-Larynges . Paris, France: Gastron Doin et Cie; 1936. 6. Baclesse F. Carcinoma of the larynx: radiotherapy of laryngeal cancer . Br J Radiol. 1949;3( (suppl) ):1-62. 7. Kirchner JA. Two hundred laryngeal cancers: patterns of growth and spread as seen in serial section . Laryngoscope . 1977;87:474-482.Crossref 8. Bryce DP. The management of laryngeal cancer . J Otolaryngol. 1979;8:105-126. 9. Nell HB III, Devine KD, Desanto LW. Laryngofissure and cordectomy for early cordal carcinoma: outcome in 182 patients . Otolaryngol Head Neck Surg. 1980; 88:79-84. 10. Kirchner JA. Growth and spread of laryngeal cancer as related to partial laryngectomy . Laryngoscope . 1975;85:1516-1521.Crossref 11. Olofsson J, Lord IJ, van Nostrand AWP. Vocal cord fixation in laryngeal carcinoma . Acta Otolaryngol (Stockh) . 1973;75:496-510.Crossref 12. Kirchner JA, Som ML. Clinical significance of fixed vocal cord . Laryngoscope . 1971;81:1029-1044.Crossref 13. Tucker GF Jr, Alonso WA, Tucker JA, Cowan CM, Druck N. The anterior commissure revisited . Ann Otol Rhinol Laryngol. 1973;82:625-636. 14. Harwood AR, Bryce DP, Rider WD. Management of T3 glottic cancer . Arch Otolaryngol. 1980;106:697-699.Crossref 15. Fisher A, Caldarelli DD, Chacko DC, Holinger LD. Glottic cancer . Arch Otolaryngol Head Neck Surg. 1986;112-519-521. 16. Pearson BW, Woods RD, Hartman DE. Extended hemilaryngectomy for T3 glottic carcinoma with preservation of speech and swallowing . Laryngoscope . 1980; 90:1950-1961.Crossref 17. Chandrachud HK, Chaurasia MK, Sinha KP. Subtotal laryngectomy with myomucosal shunt . J Laryngol Otol. 1985;99:581-588.Crossref 18. Ogura JH, Sessions DG, Spector GJ. Analysis of surgical therapy for epidermoid carcinoma of the laryngeal glottis . Laryngoscope . 1975;85:1522-1530.Crossref 19. Daly JF, Strong EW. Carcinoma of the glottic larynx . Am J Surg. 1975;130: 489-492.Crossref 20. Ogura JH, Biller HF, Wette R. Elective neck dissection for pharyngeal and laryngeal cancers: an evaluation . Ann Otol Rhinol Laryngol. 1971;80:646-653. 21. Biller HF. Delayed contralateral cervical metastasis with laryngeal and laryngopharyngeal cancers . Laryngoscope . 1971;81:1499-1502.Crossref 22. Mittal B, Marks JE, Ogura JH. Transglottic carcinoma . Cancer . 1984;53:151-161.Crossref 23. Lutz CK, Wagner RL, Johnson JT, Myers EN. Supraglottic carcinoma: patterns of recurrence . Ann Otol Rhinol Laryngol. 1990;99:12-17. 24. Johnson JT, Barnes EL, Myers EN, Schramm VL, Borochovitz D, Sigler BA. The extracapsular spread of tumors in cervical node metastasis . Arch Otolaryngol. 1981;107:725-729.Crossref 25. Leemans CF, Tiwari R, Nauta JJP, Daal I, Snow GB. Regional lymph mode involvement and its significance in the development of distant metastasis in head and neck carcinoma . Cancer . 1993;71:452-456.Crossref 26. Snyderman NL, Johnson JT, Schramm VL, Myers EN, Bedetti CD, Thearle P. Extracapsular spread of carcinoma in cervical lymph nodes—impact upon survival in patients with carcinoma of the supraglottic larynx . Cancer . 1985;56:1597-1599.Crossref 27. Merino OR, Lindberg RD, Fletcher GH. An analysis of distant metastasis from squamous cell carcinoma of the upper respiratory and digestive tracts . Cancer . 1977;40:145-151.Crossref 28. Zbaren P, Lehman W. Frequency and sites of distant metastasis in head and neck squamous cell carcinoma . Arch Otolaryngol Head Neck Surg. 1987;113: 762-764.Crossref 29. Katwall C, Sako K, Razack MS, Rao U, Bakamijian V, Shedd DP. Metastatic patterns in squamous cell carcinoma of the head and neck . Am J Surg. 1987; 154:439-442.Crossref 30. Papac RJ. Distant metastasis from head and neck cancer . Cancer . 1984;53: 342-345.Crossref 31. Johnson JT, Myers EN, Bedetti CN. Cervical lymph node metastasis . Arch Otolaryngol. 1985;111:534-537.Crossref 32. Snow GB, Annyas AA, Van Slooten EA. Prognostic factors of neck node metastasis . Clin Otolaryngol. 1982;7:185-192.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

T3 Glottic Carcinoma Revisited: Transglottic vs Pure Glottic Carcinoma

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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1995.01890020028007
Publisher site
See Article on Publisher Site

Abstract

Abstract Objective: To compare results of treatment of patients who have T3 transglottic carcinoma with patients who have T3 pure glottic carcinoma. Design: A retrospective cohort study from January 1976 to December 1990 with a minimum 2-year follow-up. Setting: Eye and Ear Hospital, University of Pittsburgh Medical Center. Patients: The medical records of 161 patients with T3 glottic carcinoma were reviewed. We excluded 17 patients who were unavailable for follow-up or who had died of other causes but were free of glottic carcinoma. Therefore, 144 patients were entered into this study—79 patients with transglottic carcinoma and 65 with pure glottic carcinoma. Intervention: Three treatment groups consisted of the following: 30 patients in whom a full course of radiation therapy failed and who subsequently underwent salvage surgery; 92 patients who underwent surgery only; and 22 patients who underwent surgery and had postoperative radiation therapy. Seventy-five patients had total laryngectomy, and 69 had total laryngectomy with neck dissection. Main Outcome Measures: Cervical metastasis, extracapsular spread, local failure, stomal recurrence, distant metastasis, and 2 years with no evidence of disease. Results: Patients with T3 transglottic carcinoma had a higher incidence of occult cervical metastasis (12% vs 9%), overall cervical metastasis (27% vs 17%), and extracapsular spread (43% vs 27%) than did patients with T3 pure glottic carcinoma. Two years of no disease was similar in these two groups (80% vs 79%). Extracapsular spread had a notable effect on distant metastasis and on 2 years of no disease. Conclusion: Patients with T3 transglottic carcinoma had a higher incidence of cervical metastasis and extracapsular spread than patients with T3 pure glottic carcinoma. Every patient with T3 transglottic carcinoma should be treated with total laryngectomy with neck dissection.(Arch Otolaryngol Head Neck Surg 1995;121:166-170) References 1. McGavran MH, Bauer WC, Ogura JH. The incidence of cervical lymph node metastasis from epidermoid carcinoma of the larynx and their relationship to certain characteristics of the primary tumor . Cancer . 1961;14:55-66.Crossref 2. Beckford NS, Myers EN. The role of total laryngectomy in the treatment of carcinoma . In: Myers EN, ed. New Dimension in Otorhinolaryngology—Head and Neck Surgery . New York, NY: Elsevier Science Publishing Co Inc; 1985:390-393. 3. American Joint Committee on Cancer. Manual for Staging of Cancer . 4th rev ed. Philadelphia, Pa: JB Lippincott; 1992:39-41. 4. UICC International Union Against Cancer . TNM: Classification of Malignant Tumors . 4th rev ed. New York, NY: Springer-Verlag Co; 1987:23-26. 5. LeRoux-Robert J. Les Epitheliomes Intra-Larynges . Paris, France: Gastron Doin et Cie; 1936. 6. Baclesse F. Carcinoma of the larynx: radiotherapy of laryngeal cancer . Br J Radiol. 1949;3( (suppl) ):1-62. 7. Kirchner JA. Two hundred laryngeal cancers: patterns of growth and spread as seen in serial section . Laryngoscope . 1977;87:474-482.Crossref 8. Bryce DP. The management of laryngeal cancer . J Otolaryngol. 1979;8:105-126. 9. Nell HB III, Devine KD, Desanto LW. Laryngofissure and cordectomy for early cordal carcinoma: outcome in 182 patients . Otolaryngol Head Neck Surg. 1980; 88:79-84. 10. Kirchner JA. Growth and spread of laryngeal cancer as related to partial laryngectomy . Laryngoscope . 1975;85:1516-1521.Crossref 11. Olofsson J, Lord IJ, van Nostrand AWP. Vocal cord fixation in laryngeal carcinoma . Acta Otolaryngol (Stockh) . 1973;75:496-510.Crossref 12. Kirchner JA, Som ML. Clinical significance of fixed vocal cord . Laryngoscope . 1971;81:1029-1044.Crossref 13. Tucker GF Jr, Alonso WA, Tucker JA, Cowan CM, Druck N. The anterior commissure revisited . Ann Otol Rhinol Laryngol. 1973;82:625-636. 14. Harwood AR, Bryce DP, Rider WD. Management of T3 glottic cancer . Arch Otolaryngol. 1980;106:697-699.Crossref 15. Fisher A, Caldarelli DD, Chacko DC, Holinger LD. Glottic cancer . Arch Otolaryngol Head Neck Surg. 1986;112-519-521. 16. Pearson BW, Woods RD, Hartman DE. Extended hemilaryngectomy for T3 glottic carcinoma with preservation of speech and swallowing . Laryngoscope . 1980; 90:1950-1961.Crossref 17. Chandrachud HK, Chaurasia MK, Sinha KP. Subtotal laryngectomy with myomucosal shunt . J Laryngol Otol. 1985;99:581-588.Crossref 18. Ogura JH, Sessions DG, Spector GJ. Analysis of surgical therapy for epidermoid carcinoma of the laryngeal glottis . Laryngoscope . 1975;85:1522-1530.Crossref 19. Daly JF, Strong EW. Carcinoma of the glottic larynx . Am J Surg. 1975;130: 489-492.Crossref 20. Ogura JH, Biller HF, Wette R. Elective neck dissection for pharyngeal and laryngeal cancers: an evaluation . Ann Otol Rhinol Laryngol. 1971;80:646-653. 21. Biller HF. Delayed contralateral cervical metastasis with laryngeal and laryngopharyngeal cancers . Laryngoscope . 1971;81:1499-1502.Crossref 22. Mittal B, Marks JE, Ogura JH. Transglottic carcinoma . Cancer . 1984;53:151-161.Crossref 23. Lutz CK, Wagner RL, Johnson JT, Myers EN. Supraglottic carcinoma: patterns of recurrence . Ann Otol Rhinol Laryngol. 1990;99:12-17. 24. Johnson JT, Barnes EL, Myers EN, Schramm VL, Borochovitz D, Sigler BA. The extracapsular spread of tumors in cervical node metastasis . Arch Otolaryngol. 1981;107:725-729.Crossref 25. Leemans CF, Tiwari R, Nauta JJP, Daal I, Snow GB. Regional lymph mode involvement and its significance in the development of distant metastasis in head and neck carcinoma . Cancer . 1993;71:452-456.Crossref 26. Snyderman NL, Johnson JT, Schramm VL, Myers EN, Bedetti CD, Thearle P. Extracapsular spread of carcinoma in cervical lymph nodes—impact upon survival in patients with carcinoma of the supraglottic larynx . Cancer . 1985;56:1597-1599.Crossref 27. Merino OR, Lindberg RD, Fletcher GH. An analysis of distant metastasis from squamous cell carcinoma of the upper respiratory and digestive tracts . Cancer . 1977;40:145-151.Crossref 28. Zbaren P, Lehman W. Frequency and sites of distant metastasis in head and neck squamous cell carcinoma . Arch Otolaryngol Head Neck Surg. 1987;113: 762-764.Crossref 29. Katwall C, Sako K, Razack MS, Rao U, Bakamijian V, Shedd DP. Metastatic patterns in squamous cell carcinoma of the head and neck . Am J Surg. 1987; 154:439-442.Crossref 30. Papac RJ. Distant metastasis from head and neck cancer . Cancer . 1984;53: 342-345.Crossref 31. Johnson JT, Myers EN, Bedetti CN. Cervical lymph node metastasis . Arch Otolaryngol. 1985;111:534-537.Crossref 32. Snow GB, Annyas AA, Van Slooten EA. Prognostic factors of neck node metastasis . Clin Otolaryngol. 1982;7:185-192.Crossref

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Feb 1, 1995

References