The importance of vocal cord mobility in T2 laryngeal cancer

Wiggenraad, Ruud; Terhaard, C.; Hordijk, G. J.; Ravasz, L

doi:10.1016/0167-8140(90)90112-a

Cited by 35 publications

(21 citation statements)

References 11 publications

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“…Thus, local control was 90% and survival after (10,20,23). 16 out of 24 patients with recurrent tumours received salvage surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Tumour-related factors with prognostic value usually reflect different aspects of tumour extension on and beyond the true vocal cord (10-12, 16, 17, 19, 20). Impaired cord mobility has been described as a significant risk factor in several reports (10,15,17,19,23), and a subdivision of T2 tumours into a T2b group with impaired mobility has been proposed (2). Other tumour-related factors discussed are tumour size (21), involvement of the anterior commissure (7,8,15,20), and histologic grade (6,10,16,21).…”

Section: Discussionmentioning

confidence: 99%

“…In patients with T2 tumours the results are less favourable. Thus, local control is reported between 60 and 85% (5,10,15,20,23,(24)(25)(26) and survival after salvage surgery between 80 and 94%…”

Section: Discussionmentioning

confidence: 99%

“…Radiotherapy offers the possibility of preservation of voice quality and local control rates between 80% to 95% and 65% to 85% for T1 and T2 tumours respectively (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Factors related to tumour (6, 7, 10, 1 I, 13, 15, 19-21, 23), patient (15,21,23) and treatment (12, 14, 16-18, 22, 24-27), explaining the heterogeneity in treatment outcome, have been searched for, especially among T2 tumours. Primary radiotherapy reserving surgery for recurrent disease has been the treatment policy in the present series.…”

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confidence: 99%

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Primary Radiotherapy of Tl and T2 Glottic Carcinoma: Analysis of treatment results and prognostic factors in 223 patients

et al. 1996

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“…Thus, local control was 90% and survival after (10,20,23). 16 out of 24 patients with recurrent tumours received salvage surgery.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Primary Radiotherapy of Tl and T2 Glottic Carcinoma: Analysis of treatment results and prognostic factors in 223 patients

et al. 1996

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“…2 Impaired vocal cord motion has been associated with worse local control and survival after non-surgical therapy. 3 Fixed vocal cord lesions are indicative of deep muscle or cartilage infiltration and thus, under the AJCC classification, they are given at least a T3 designation (i.e. at least stage III disease).…”

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confidence: 99%

Does Vocal Cord Fixation Preclude Nonsurgical Management of Laryngeal Cancer?

Solares¹,

Wood²,

Rodriguez³

et al. 2009

The Laryngoscope

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The presence of pre-treatment vocal cord fixation has been reported as a predictor of a poor functional outcome following chemoradiotherapy, 1 with treatment failure more often requiring salvage laryngectomy.2 Impaired vocal cord motion has been associated with worse local control and survival after non-surgical therapy. 3Fixed vocal cord lesions are indicative of deep muscle or cartilage infiltration and thus, under the AJCC classification, they are given at least a T3 designation (i.e. at least stage III disease). 4 Return of vocal cord function after non-surgical therapy, however, may predict a better outcome. [5][6][7] At our institution concurrent chemoradiotherapy has been used as a definitive treatment option for SCC of the larynx. Our purpose was to cull our experience with T3/T4 laryngeal SCC and pre-treatment vocal cord fixation to evaluate non-surgical management outcomes and further to assess the implications of persistent post-treatment vocal cord immobility.Twenty three patients with squamous cell cancer of the larynx treated with concurrent chemoradiotherapy with pre-treatment vocal cord fixation were identified: 19 males and 4 females. The median age was 59 (range 39-73) years. The primary site was located in the supraglottic larynx in 11 (47.8%) and glottic larynx in 12 (52.2%). Eight (34.8%) patients were treated with once daily radiation, the remaining 15(65.2%) were treated twice daily. All but 1 patient were able to complete both courses of concurrent chemotherapy with their radiation. Using the 2002 AJCC staging system, 14 patients (60.9%) had T3 tumors and 9 (39.1%) had T4 tumors. None of these variables differed statistically between the two groups of patients.With a median follow-up of 68 (range 34-191) months, the projected five-year overall survival was 100% among patients who recovered function vs. 25% among those who did not (p < 0.001) [ Figure 1]. Five-year freedom from recurrence was 86.7% among patients who recovered function vs. 25% among those who did not (p < 0.001) [ Figure 2]Five-year local control without surgery was 86.7% among patients who recovered function vs. 30% among those who did not (p = 0.003) [ Figure 3]. A laryngectomy was required and was successful in 2 of the 15 (13.3%) patients from the group that recovered function. Four of the eight patients (50%) who did not recover function underwent a total laryngectomy. Of these, two patients had persistent disease at the primary site and total laryngectomy achieved local control, and two patients had primary site recurrence that could not be controlled with surgery. Two additional patients in the group not recovering function were not candidates for surgical salvage, one never achieved local control while the other had an extensive local recurrence. Recurrences were diagnosed within 2 years of treatment. Ultimately, of the 8 patients who did not recover function, four patients died of local disease, 2 patients died of distant disease, and 2 patients were cured.Persistent tracheotomy, feeding tube dependence or laryngec...

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Meta-analysis of Impaired Vocal Cord Mobility as a Prognostic Factor in T2 Glottic Carcinoma

McCoul¹,

Har‐El²

2009

Arch Otolaryngol Head Neck Surg

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This meta-analysis indicates that impaired vocal cord mobility has a negative impact on local disease control and ultimate disease control in patients receiving primary radiotherapy for the treatment of T2 glottic carcinoma. We recommend that the subdivision of glottic cancer to T2a and T2b be reviewed and considered by the American Joint Committee on Cancer for inclusion in the Cancer Staging Manual.

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The importance of vocal cord mobility in T2 laryngeal cancer

Cited by 35 publications

References 11 publications

Primary Radiotherapy of Tl and T2 Glottic Carcinoma: Analysis of treatment results and prognostic factors in 223 patients

Primary Radiotherapy of Tl and T2 Glottic Carcinoma: Analysis of treatment results and prognostic factors in 223 patients

Does Vocal Cord Fixation Preclude Nonsurgical Management of Laryngeal Cancer?

Meta-analysis of Impaired Vocal Cord Mobility as a Prognostic Factor in T2 Glottic Carcinoma

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