Endoscopic cordectomy. a proposal for a classification by the Working Committee, European Laryngological Society

Remacle, Marc; Eckel, Hans Edmund; Antonelli, A.; Brasnu, Daniel; Chevalier, Dominique; Friedrich, Gerhard; Olofsson, Jan; Rudert, H.; Thumfart, Walter F.; Vincentiis, Marco de; Wustrow, T. P. U.

doi:10.1007/s004050050228

Cited by 430 publications

(303 citation statements)

References 15 publications

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“…The classification comprises Eight types of cordectomies: a Subepithelial cordectomy (type I), which is resection of the epithelium; a Subligamental cordectomy (type II), which is a resection of the epithelium, Reinke's space and vocal ligament; Transmuscular cordectomy (type III), which proceeds through the vocalis muscle; Total cordectomy (type IV); Extended cordectomy, which encompasses the contralateral vocal fold and the anterior commissure (type Va); Extended cordectomy, which includes the arytenoid (type Vb); Extended cordectomy, which encompasses the subglottis (type Vc); and Extended cordectomy, which includes the ventricle (type Vd). Indications for performing those cordectomies may differ from surgeon to surgeon [27].…”

Section: Larynxmentioning

confidence: 99%

Site-wise Differences in Adequacy of the Surgical resection Margins in Head and Neck Cancers

Vidhyadharan

Augustine

Kudpaje

et al. 2014

Indian J Surg Oncol

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Adequacy of surgical resection decided by the margin status is important in attaining a good local control and better survival in Head and neck Cancers. Conventionally, a measured distance between the tumor edge and the cut edge of the specimen is taken as the margin. A margin more than 5 millimeter (mm) is considered clear, less than 5 mm is close and less than one mm is denoted as involved. The concept of this adequacy varies between the different sites and subsites in head and neck. The purpose of this paper is to review the current evidence that describes the adequacy of surgical margin status and their variability among the sites and sub-sites in the head and neck.

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Section: Larynxmentioning

confidence: 99%

Site-wise Differences in Adequacy of the Surgical resection Margins in Head and Neck Cancers

Vidhyadharan

Augustine

Kudpaje

et al. 2014

Indian J Surg Oncol

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“…The patients had been previously treated by excisional biopsy, namely type I cordotomy/cordectomy, according to the classification of the Working Committee, European Laryngological Society (11,12), using 'cold' microinstruments and/or CO 2 Acublade 400 Lumenis laser, Sharplan 40C and Zeiss surgical microscope during microlaryngoscopy.…”

Section: Methodsmentioning

confidence: 99%

Chemoprevention using folic acid for dysplastic lesions of the larynx

Mesolella

Iengo

Testa

et al. 2017

Molecular and Clinical Oncology

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Abstract. Folate deficiency may be directly associated with carcinogenesis. Folate supplementation may reduce the risk of progression in a mucosa that is already genetically altered. The aim of the present study was to determine the role of folic acid in the treatment of mild and moderate laryngeal dysplasia recurring after surgery. The data obtained by laryngoscopy, measurement of serum folate levels and functional vocal assessment with the GIRBAS scale and VHI questionnaire were compared in patients who had received folic acid with a homogeneous group of patients with dysplasia who had not undergone any therapy. A total of 24 patients suffering from recurrence of mild or moderate laryngeal dysplasia (n=12, group A) were treated with 400 mg folic acid per os, once daily for 6 months. The patients in group B (n=12) received no treatment and were used as the control group. In group A, 7 (58%) patients exhibited a complete response, with clinically evident regression of leukoplakia, 3 (25%) displayed a partial decrease in the lesions with reduced volume of the area involved, whereas 2 patients exhibited no change. As regards patients in control group B, 8 (67%) exhibited no change, in 1 case there was a spontaneous regression, and in 3 (25%) there was disease progression with suspected malignant transformation, leading to repeat surgery. Therefore, folate deficiency may be considered to be a factor predisposing to precancerous lesions, and dietary folate supplementation may prevent and reduce the emergence of cancer. IntroductionCarcinogenesis is a multistep process including genetic alterations that develop over time, and it is associated with metabolic alterations that may promote neoplastic progression (1).Metabolic processes that use folates interfere with the synthesis, repair and methylation of DNA, as they are involved in the synthesis of purine and of pyrimidine bases and serve as methyl donors in the methionine cycle (2).Folate deficiency encourages the assimilation of uracil in the DNA, which causes a genomic instability characterized by the formation of single and double breaks in the DNA filaments, chromosomal breakages and the formation of micronuclei (2).It is obvious, therefore, that folate deficiency may be directly implicated in promoting carcinogenesis (3,4). The chronological succession of certain types of metaplasia of the laryngeal epithelium with laryngeal cancer may identify a group of lesions that are defined as 'precancerous' (5).Several events that take place during the transformation of precancerous lesions to cancer may be controlled and even reversed by removing the possible trigger factors (e.g., discontinuing smoking and following a balanced diet) and by using carcinogenesis inhibitors (chemoprevention) (6). Chemoprevention is the use of chemical or natural substances to reverse, suppress or prevent conversion of precancerous to invasive lesions (7). At this time, chemoprevention may be defined as the use of agents to prevent the appearance of precancerous lesions, or delay or revers...

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“…Endolaryngeal surgery involves the en bloc resection of a tumor with a safety margin (4). In contrast, the target volume in RT encompasses the entire larynx, even for T1a glottic cancer, in which the entire tumor is limited to one vocal cord (5).…”

Section: Introductionmentioning

confidence: 99%

Volumetric modulated arc radiotherapy of the whole larynx, followed by a single affected vocal cord, for T1a glottic cancer: Dosimetric analysis of a case

Yeo

2016

Molecular and Clinical Oncology

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Abstract. Radiation therapy (RT) and endolaryngeal surgery are standard treatments for early-stage glottic cancer. They have closely matched oncological outcomes; however, it is debatable which method is superior in terms of functional outcomes. Several dosimetric studies have demonstrated that, compared with conventional RT, intensity-modulated RT (IMRT) reduces unnecessary radiation of the adjacent normal tissues, including the carotid artery and thyroid gland. However, RT targets the whole larynx, whereas endolaryngeal surgery is a highly focused treatment involving the en bloc resection of a tumor with safety margins. For T1a glottic cancer, in which the tumor is limited to one vocal cord, the technical feasibility of targeting IMRT on the single vocal cord affected has been investigated; however, the clinical feasibility and the possibility of inferior local control remain to be elucidated. In the present case study, IMRT was used to treat the whole larynx first, and then to treat a single vocal cord. The patient in the present study had T1a glottic cancer, and received volumetric modulated arc therapy with a total dose of 63 Gy/28 fractions. The first treatment phase (40.5 Gy/18 fractions) targeted the whole larynx to eliminate subclinical disease. The second treatment phase (22.5 Gy/10 fractions) targeted only the involved vocal cord. During this treatment phase, the exposure of the non-involved right vocal cord, the right carotid artery and the thyroid gland to the radiation was lower compared with the continuation of the initial treatment approach. These findings suggested that changing the target volume from the whole larynx to the affected vocal cord during the course of IMRT is feasible for T1a glottic cancer, and that it may reduce functional side effects while maintaining oncological outcomes.

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Endoscopic cordectomy. a proposal for a classification by the Working Committee, European Laryngological Society

Cited by 430 publications

References 15 publications

Site-wise Differences in Adequacy of the Surgical resection Margins in Head and Neck Cancers

Site-wise Differences in Adequacy of the Surgical resection Margins in Head and Neck Cancers

Chemoprevention using folic acid for dysplastic lesions of the larynx

Volumetric modulated arc radiotherapy of the whole larynx, followed by a single affected vocal cord, for T1a glottic cancer: Dosimetric analysis of a case

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