Pathologic Evaluation of Primary Laryngeal Anterior Commissure Carcinoma Both in Patients who have Undergone Open Surgery as Initial Treatment and in those who have Undergone Salvage Surgery after Irradiation Failure

Ahmed, Wael A.; Suzuki, Kenji; Horibe, Yoshimune; Kato, Ichiro; Fujisawa, Toshiyuki; Nishimura, Yoichi

doi:10.1177/014556131109000508

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…Regarding RT, there is a risk of underdosage at the air–tissue interface. The AC is the laryngeal subsite closest to this interface, and so this might lead to a poorer coverage of the prescribed dose in that subsite . As for TLM, laryngeal exposure is one of the most important factors affecting the outcomes of glottic cancer .…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of anterior commissure involvement in T1 glottic cancer: A systematic review and meta‐analysis

Tulli

Bondi

et al. 2019

The Laryngoscope

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Objective The anterior commissure is considered a laryngeal subsite, but it is not taken into account in the current T‐staging system. The impact of anterior commissure involvement (ACI) on the oncologic outcomes of T1 glottic tumors has not been well defined and remains controversial. The aim of this study was to assess the influence of ACI in the prognosis of T1 glottic tumors. Methods A systematic review and meta‐analysis of observational studies was performed by including studies published up to July 2019. Studies were selected if they had investigated the local control rate (LCR) at 5 years of clinical stage I (T1 and N0) glottic squamous cell carcinoma with and without ACI. The difference in LCR at 5 years between T1 glottic tumors without and with ACI was evaluated. Results The meta‐analysis showed that the difference in LCR at 5 years between T1 glottic tumors without and with ACI is 12% (95% confidence interval: 8%‐16%, p < 0,0001, I2 = 34.81%). Conclusions Our study pointed out that the anterior commissure involvement is a negative prognostic factor in LCR at 5 years for T1 glottic tumors. Our results suggest the need to consider ACI in the T staging of glottic tumors. Laryngoscope, 130:1932–1940, 2020

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Section: Discussionmentioning

confidence: 99%

The prognostic value of anterior commissure involvement in T1 glottic cancer: A systematic review and meta‐analysis

Tulli

Bondi

et al. 2019

The Laryngoscope

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“…Therapeutic strategies of laryngeal carcinomas with AVC involvement are still controversial. Radiotherapy is less effective in treating this area 15 . Surgery by transcervical approaches with resection of suspectedly invaded cartilage is recommended to avoid relapse 14 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of CT and MRI in Diagnosis of Laryngeal Carcinoma with Anterior Vocal Commissure Involvement

Jian-hui¹,

Zhao²,

Zenghong³

et al. 2016

Sci Rep

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This study aimed to compare the accuracy of CT and MRI in determining the invasion of thyroid cartilage by and the T staging of laryngeal carcinoma with anterior vocal commissure (AVC) involvement. A total of 26 cases of laryngeal carcinomas with AVC involvement from May 2012 to January 2014 underwent enhanced CT and MRI scan, out of whom 6 patients also underwent diffusion-weighted magnetic resonance imaging(DWI). T staging and thyroid cartilage involvement were evaluated. All the surgical specimens underwent serial section and were reviewed by two senior pathologists independently. When compared with pathologic staging, the accuracy was 88.46% (23/26) of MRI scan (with a 95% confidence interval 37~77%) and 57.69% (15/26) of CT scan (with a 95% confidence interval 70~98%), respectively (P < 0.01). We also reported three cases who were misdiagnosed on CT or MRI about either the thyroid cartilage was involved or not, and one case of preliminary study of DWI. Compared to CT, MRI exhibited a higher accuracy rate on T staging of laryngeal carcinomas with AVC involvement. Combined utility of CT and MRI could help improve the accuracy of assessment of thyroid cartilage involvement and T staging of laryngeal carcinomas with AVC involvement.

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“…T1 lesions are bound by the conus elasticus, which forms a firm barrier against tumour growth. Spread beyond the vocal cord frequently occurs through invasion of the anterior commissure, as the attachment of Broyles’ ligament onto the thyroid cartilage serves as a weak point, where tumour may invade through the cricothyroid membrane into the laryngeal cartilage and supraglottic or subglottic spaces ( 10 ). Anterior commissure invasion appears to be the most important prognostic determinant for local control for ESGC ( 11 ).…”

Section: Patterns Of Disease Spreadmentioning

confidence: 99%

Early-Stage Glottic Squamous Cell Carcinoma in the Era of Image-Guided Radiotherapy

et al. 2021

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Early-stage squamous cell cancer (SCC) of the glottis has a good prognosis. Therefore, patients have long survival outcomes and may potentially suffer from late toxicities of radiotherapy. Radiotherapy with a conventional parallel-opposed-pair or anterior-oblique beam arrangements for stage 1 and 2 glottic SCC have field borders that traditionally cover the entire larynx, exposing organs-at-risk (e.g. carotid arteries, contralateral vocal cord, contralateral arytenoid and inferior pharyngeal constrictor muscles) to high radiation doses. The potential long-term risk of cerebrovascular events has attracted much attention to the dose that carotid arteries receive. Swallow and respiratory motion of laryngeal structures has been an important factor that previously limited reduction of the radiation treatment volume. Motion has been evaluated using multiple imaging modalities and this information has been used to calculate PTV margins for generation of more limited target volumes. This review discusses the current literature surrounding dose-effect relationships for various organs-at-risk and the late toxicities that are associated with them. This article also reviews the currently available data and effects of laryngeal motions on dosimetry to the primary target. We also review the current limitations and benefits of a more targeted approach of radiotherapy for early-stage glottic SCCs and the evolution of CT-based IGRT and MR-guided radiotherapy techniques that may facilitate a shift away from a conventional 3D-conformal radiotherapy approach.

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Pathologic Evaluation of Primary Laryngeal Anterior Commissure Carcinoma Both in Patients who have Undergone Open Surgery as Initial Treatment and in those who have Undergone Salvage Surgery after Irradiation Failure

Cited by 3 publications

References 20 publications

The prognostic value of anterior commissure involvement in T1 glottic cancer: A systematic review and meta‐analysis

The prognostic value of anterior commissure involvement in T1 glottic cancer: A systematic review and meta‐analysis

Comparison of CT and MRI in Diagnosis of Laryngeal Carcinoma with Anterior Vocal Commissure Involvement

Early-Stage Glottic Squamous Cell Carcinoma in the Era of Image-Guided Radiotherapy

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