Evaluation of treatment results with regard to initial anterior commissure involvement in early glottic carcinoma treated by external partial surgery or transoral laser microresection.

Sachse F, Stoll W, Rudack C

Abstract

BACKGROUND: Modalities of surgical treatment of early glottic carcinoma include transoral laser microresection and external partial surgery. METHODS: This is a retrospective analysis of 119 glottic carcinomas treated by external partial surgery (57 pT1a, 1 pT1b, 10 pT2) or transoral laser microresection (46 pT1a, 4 pT1b, 1 pT2) with special regard to initial anterior commissure involvement. RESULTS: Local recurrence in external partial surgery was 12%. Three- and 5-year local control was 86%. Local recurrence in transoral laser microresection was 16%. Three- and 5-year local control was 88% and 70%, respectively. No significant correlation was found between local control and surgical approach. An analysis of all 119 tumor revealed that anterior commissure involvement significantly decreased local control. CONCLUSION: Initial anterior commissure involvement was associated with a higher risk of local recurrence. Overall, treatment of glottic carcinoma involving the anterior commissure requires much experience and advanced surgical skills regardless which technique is preferred.