What Have Whole Organ Sections Contributed to the Treatment of Laryngeal Cancer?

Abstract

The study of whole organ sections of laryngectomy specimens has demonstrated the patterns by which cancer spreads from one part of the larynx and hypopharynx to another. These studies have also demonstrated the fibroelastic membranes and ligaments that form the boundaries of intralaryngeal compartments within which cancer is confined in its early stages. They thus have added support to the concept of partial laryngectomy for selected lesions and have illustrated the features of those types of laryngeal cancer that have not responded well to radiotherapy. Whole organ sections of laryngectomy specimens have allowed a more accurate interpretation of preoperative computed tomography and magnetic resonance imaging and have provided a reliable basis for clinical staging.

Has the Degree of Contrast Enhancement with MR Imaging in Laryngeal Carcinoma Added Value to Anatomic Parameters Regarding Prediction of Response to Radiation Therapy?

“…21 The poor blood supply of the PES may cause hypoxia in tumor tissue and may explain its relative resistance to RT. 22,23 In accordance with previous studies, tumor involvement to the PES in supraglottic carcinoma is a strong independent prognostic factor for the tumor recurrence. 10,[24][25][26] The low degree of contrast enhancement in this study may therefore be expected in patients with tumor involvement to the PES and may correlate with a poor prognosis (Fig 4).…”

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

“…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.…”

Resultados oncológicos da laringectomia parcial no carcinoma glótico inicial

“…Já os tumores glóticos com estadiamentos T1b e T2 são de indicação cirúrgica aberta, embora alguns autores preconizem ressecção endoscópica nesses estádios 14,15 . A justificativa para a cirurgia aberta é que nos tumores T1b, em que a regra é o envolvimento da comissura anterior (ocorre somente em 30% dos T1a), é citada a expressiva redução do controle da doença, seja com radioterapia seja com a cirurgia, com taxas de recidivas maiores que em qualquer outra região da laringe 16,17 . Esse comportamento é explicado pelo fato da mucosa laríngea nesse ponto ficar muito próxima da cartilagem tireóidea e a neoplasia pode infiltrar as fibras do ligamento vocal e, pelos vasos sangüíneos, penetrar na cartilagem e membrana cricotireóidea.…”