Clinical Underestimation of Laryngeal Cancer: Predictive Indicators

Nakayama, Meijin; Brandenburg, James H.

doi:10.1001/archotol.1993.01880210038006

Cited by 50 publications

(22 citation statements)

References 19 publications

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“…5,43,44 Furthermore, in many cases, the cartilage at the anterior commissure is ossified; anatomically there is no perichondrium at this level and Broyles ligament may be ruptured, making the anterior commissure a weak spot for tumor infiltration. 45,46 Tumors involving the anterior commissure generally have a higher risk of local recurrence after TLM, be they Tis, T1a, T1b, or T2. [47][48][49][50][51][52][53][54][55][56] For infiltrating, particularly ulcerating, tumors, the higher recurrence rate is possibly due to deep superior and inferior extensions along the inner perichodrium of the thyroid cartilage, with microscopic spreading to the preepiglottic space and/or to the subglottis but also possibly to microscopic cartilage invasion at this weak spot in the cartilage.…”

Section: Anterior Commissurementioning

confidence: 99%

Contemporary Surgical Management of Early Glottic Cancer

Hartl

Brasnu

2015

Otolaryngologic Clinics of North America

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Section: Anterior Commissurementioning

confidence: 99%

Contemporary Surgical Management of Early Glottic Cancer

Hartl

Brasnu

2015

Otolaryngologic Clinics of North America

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The absence of a universally accepted anatomic and clinical definition of the AC region and the lack of consideration of AC involvement in the principal T stages by the current T classifications of glottic cancer (AJC,21 UICC22) add much to the problem. Since a careful analysis of the human larynx during development allowed us to identify the AC subsite with better detail than previously known, as shown in part I of this paper, 23 we have tried to transfer the results of that study to clinical medicine, as follows.…”

Section: Introductionmentioning

confidence: 99%

Carcinoma of the Anterior Commissure of the Larynx: II. Proposal of a New Staging System

Rucci

Gammarota²,

Gallo³

1996

Ann Otol Rhinol Laryngol

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On the basis of embryology and clinical experience, we have defined here an anterior commissure (AC) subsite of the human larynx and have addressed the issue as to whether the degree of involvement of this subsite is related to the outcome of glottic cancer, in terms of local control within 5 years of therapy. Retrospective analysis of 534 patients included 1) classification of patients according to the TNM, 2) actuarial evaluation of the outcome, 3) reclassification of patients according to the involvement of the AC subsite, and 4) reevaluation of the outcome according to this latter classification. The results showed that the outcome was not well correlated with TNM classification, whereas patients with progressively heavier involvement of the AC subsite had a progressively worse outcome. On the basis of these data, we suggest that TNM classification of cancer involving the AC be implemented by and AC classification, in order to better forecast the prognosis and design specific conservative surgery.

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“…Needless to say, well-documented clinical and pathological observations are the most significant element. Wholeorgan section is an ideal method of studying the relationship between cancer and the submucosal structures and, hence, provides a reliable basis for clinical staging [8,9] . By conducting clinicopathological analyses of 50 supracricoid laryngectomized specimens, we intended to evaluate the evidence base supporting minimal margins in SCL-CHEP.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Analyses of Fifty Supracricoid Laryngectomized Specimens: Evidence Base Supporting Minimal Margins

Nakayama

Holsinger²,

Okamoto

et al. 2009

ORL

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Objectives: Supracricoid laryngectomy (SCL) is a reliable laryngeal preservation surgery. However, close surgical margins are often inevitable. Based on clinicopathological analyses of supracricoid laryngectomized specimens, we evaluated the evidence base supporting minimal margins. Methods: The distance between tumor edge and resected margin was measured macro- and microscopically at the anterior, posterior, superior and inferior edges, using 50 surgical specimens. The margins were correlated with pathological T staging and the prognoses. Results: The anterior and posterior margins were the shortest, and the superior margin was the longest. The inferior margin was the only edge at which a positive margin was encountered. Cancer extending 10 mm below the glottal free edge significantly decreased the inferior margin. Conclusions: The surgical potential of SCL with cricohyoidoepiglottopexy was confirmed to be able to cope with tumor extensions showing margins of a few millimeters at the anterior, posterior and superior ends. Accurate assessment and management at the inferior margin is the key to stable local control.

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Clinical Underestimation of Laryngeal Cancer: Predictive Indicators

Cited by 50 publications

References 19 publications

Contemporary Surgical Management of Early Glottic Cancer

Contemporary Surgical Management of Early Glottic Cancer

Carcinoma of the Anterior Commissure of the Larynx: II. Proposal of a New Staging System

Clinicopathological Analyses of Fifty Supracricoid Laryngectomized Specimens: Evidence Base Supporting Minimal Margins

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