A Therapeutic Approach to Early Vocal Cord Carcinoma

Amornmarn, Rumpa; Prempree, Thongbliew; Viravathana, Thavinsakdi; Donavanik, Viroon; Wizenberg, Morris J.

doi:10.3109/02841868509136059

Cited by 62 publications

(22 citation statements)

References 12 publications

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“…Several series with local control rates in excess of 90% have been reported (5,12,15,16,20,25,26). Survival after salvage surgery is reported as being close to 100% (12,16,20).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, local control was 90% and survival after (10,20,23). 16 out of 24 patients with recurrent tumours received salvage surgery.…”

Section: Discussionmentioning

confidence: 99%

“…These were T-stage, number of involved sites, cord mobility and subglottic extension. Subglottic extension has been recognized by others as a possible risk factor of unclear significance (7,10,19,20). …”

Section: Discussionmentioning

confidence: 99%

“…In patients with T2 tumours the results are less favourable. Thus, local control is reported between 60 and 85% (5,10,15,20,23,(24)(25)(26) and survival after salvage surgery between 80 and 94%…”

Section: Discussionmentioning

confidence: 99%

“…Impaired cord mobility has been described as a significant risk factor in several reports (10,15,17,19,23), and a subdivision of T2 tumours into a T2b group with impaired mobility has been proposed (2). Other tumour-related factors discussed are tumour size (21), involvement of the anterior commissure (7,8,15,20), and histologic grade (6,10,16,21).…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Primary Radiotherapy of Tl and T2 Glottic Carcinoma: Analysis of treatment results and prognostic factors in 223 patients

et al. 1996

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“…Several series with local control rates in excess of 90% have been reported (5,12,15,16,20,25,26). Survival after salvage surgery is reported as being close to 100% (12,16,20).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, local control was 90% and survival after (10,20,23). 16 out of 24 patients with recurrent tumours received salvage surgery.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Primary Radiotherapy of Tl and T2 Glottic Carcinoma: Analysis of treatment results and prognostic factors in 223 patients

et al. 1996

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Importance of Anterior Commissure in Recurrence of Early Glottic Cancer After Laser Endoscopic Resection

Chone¹,

Yonehara²,

Martins³

et al. 2007

Arch Otolaryngol Head Neck Surg

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The Role of Hemilaryngectomy in the Management of T1 Vocal Cord Cancer

Mendenhall¹,

Parsons²,

Cassisi³

et al. 1990

Archives of Otolaryngology - Head and Neck Surgery

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To the Editor.\p=m-\Rothfieldet al1 recently published a report on a series of 54 patients with T1 squamous cell carcinoma of the true vocal cord treated with hemilaryngectomy; 43 of 54 patients were operated on for de novo lesions. The authors are to be commended for their excellent treatment results. However, they make several observations with which I take issue:1. The authors categorically state that hemilaryngectomy offers better cure rates than external-beam irradiation. They reported local control with hemilaryngectomy in 42 (98%) of 43 patients with de novo lesions; included were 3 patients who died of intercurrent disease. In a study of a series of patients with T1 vocal cord cancers recently published by the University of Florida (Gainesville), local control with irradiation was achieved in 144 (93%) of 155 patients suitable for a conservative laryngeal procedure.2 Eleven patients who died of intercurrent disease with the primary site continuously disease-free within 2 years of treatment were not included in the local control analysis, biasing the comparison against the radiother¬ apy series. Rothfield et al considered patients who developed local recur¬ rence more than 5 years from treat¬ ment to have developed second malig¬ nancies; these patients were coded as having a local recurrence in our study. This further biases the comparison against the radiotherapy series. The significance level between the treat¬ ment groups is = .22 (42 of 43 vs 144 of 155). The overall rate of local control with voice preservation for the entire radiotherapy series (no exclusions) was 157 (95%) of 166. I submit that these results are essentially the same as those presented by Rothfield et al, and that hemilaryngectomy and irra-diation offer equivalent local control rates. The likelihood of local control with irradiation is related to total dose, dose per fraction, and overall treatment time, so that local control with an optimal treatment schedule is better than the overall rate of 93%.3 2. The authors observe that hemi¬ laryngectomy provides more accurate staging than does management with irradiation. However, because the like¬ lihood of local control with hemilaryn¬ gectomy is the same as with irradia¬ tion, this additional information is useless.3. The authors note that follow-up is more straightforward and that multi¬ ple endoscopies with biopsy are avoided after hemilaryngectomy. In fact, there is far less anatomic distor¬ tion of the larynx following irradiation compared with hemilaryngectomy, so that irradiated patients are easier to observe. Additionally, we do not per¬ form endoscopy and/or biopsy on a patient following radiotherapy unless there is clinical evidence of recurrent disease; the indications for repeat fol¬ low-up endoscopy are the same no matter what the initial treatment.4. The authors state that the risk of a radiation-induced malignancy is avoided by using hemilaryngectomy. Multiple studies have shown no in¬ creased risk of second epithelial ma¬ lignancy in patients with head and neck cancer who ...

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A Therapeutic Approach to Early Vocal Cord Carcinoma

Cited by 62 publications

References 12 publications

Primary Radiotherapy of Tl and T2 Glottic Carcinoma: Analysis of treatment results and prognostic factors in 223 patients

Primary Radiotherapy of Tl and T2 Glottic Carcinoma: Analysis of treatment results and prognostic factors in 223 patients

Importance of Anterior Commissure in Recurrence of Early Glottic Cancer After Laser Endoscopic Resection

The Role of Hemilaryngectomy in the Management of T1 Vocal Cord Cancer

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