Glottic Laryngeal Carcinoma Research Articles

Clinical analysis of biomaterial-silicone keel complex in the vocal folds adhesion treatment

Objective:To retrospectively analyze the clinical effect of biomaterial combined with silicone keel technology in the prevention and treatment of vocal folds adhesion. Methods:The basic data, perioperative conditions and prognosis of 21 cases of vocal folds adhesion treated by biofilm-silicone keel complex were retrospectively analyzed in Huashan Hospital Fudan University. Results:A total of 21 patients were enrolled in this study（19 males（90.5%）, 2 females（9.5%）. Among these patients, 18 cases of early glottic laryngeal carcinoma（T1b）, 1 case of bilateral vocal folds leukoplecta and 2 cases of postoperative vocal folds adhesion. No accidental rupture of the silicone keel occurred during perioperative period, and the silicone keel was removed in 22.4±2.6 days. All patients were reviewed after removing the silicone keel, the overall effective rate was 90.5%（19/21）. Postoperative complications occurred in 5 patients（1 laryngeal infection, 4 granulation tissue hyperplasia）, all of whom were cured after conservative treatment. Conclusion:This study explored the feasibility of biomaterial in the treatment of vocal folds adhesion. The biomaterial-silicone keel complex technology is simple to operate and has effect on the prevention of vocal folds adhesions, which is worth of clinical promotion.

Outcome of Patients with Early Glottic Laryngeal Carcinoma Treated with Radical Radiotherapy

Introduction: Glottic cancer is the most common laryngeal cancer and it has the most favorable prognosis, mainly if diagnosed early. Ideally, early glottic cancer (T1–T2 N0) should be managed with a single modality either microsurgery or definitive Radiotherapy. The local control rate with definitive radiotherapy is approximately 83–95% for T1 and 70–80% for T2 lesions. This study intends to find out the treatment outcome in early glottic cancer treated with radical radiation treatment from 1st January 2014 to 31st December 2019 at our center. Methods: This was a retrospective analysis of medical records and radiation charts of all patients of early stage glottis cancer who underwent radiation treatment from 1st January 2014 to 31st December 2019 at our centre. The statistical analysis was done using SPSS version 20.0.Continuous variables such as age was summarized in terms of either mean ± Standard Deviation or median (inter quartile range) depending on the statistical distribution of data. Categorical variables were e pressed in terms of frequency and percentage. Survival analysis was done using Kaplan Meier curves. Results: A total of 91 patients underwent radical radiation for early glottic carcinoma at our centre. The median age was 63 years (42-85 years). Out of them 94% were males and 6% were females. 78% of patients had stage 1 disease and 22% had stage 11 disease. 52% of patients had co morbidities and 48% did not have any comorbidity All cases had Squamous cell carcinoma histology. 59% of patients had anterior commissure involvement. 12 out of 91 (13%) patients developed local recurrence on follow up. The five year disease free survival was 84.3%. The five year overall survival was 87.7%. There was a statistically significant difference in survival between stage I and stage II. Conclusion: For T1–T2 glottic carcinomas, definitive RT can provide a good term local control and survival with the preservation of the normal structure and function of larynx.

Oncological outcomes of surgical management for T2N0M0 glottic laryngeal squamous cell carcinoma

AbstractObjectivesThe research aimed to evaluate the clinical treatment outcomes of T2N0M0 glottic laryngeal squamous cell carcinoma (LSCC) patients who underwent laryngectomy.MethodsRetrospective review of 533 T2N0M0 glottic LSCC patients.ResultsFive‐year cancer‐specific survival (CSS) rate was 90.0%, and the overall survival (OS) rate was 89.1%. No statistically difference was found between the patients who have undergone total laryngectomy (5‐year disease‐free survival[DFS] = 80.7%, and the CSS = 86.7%) and those who have had partial laryngectomy (the 5‐year DFS = 85.3%, and CSS = 91.1%). There was no difference in the CSS and DFS rates between patients with negative margins and those with positive margins following postoperative radiotherapy (PORT) ± chemotherapy (the CSS: 90.8% vs. 81.8%, p = 0.458 and 5‐year DFS: 84.6% vs. 79.5%, p = 0.371). Patients who underwent vertical partial laryngectomy (VPL) had better survival (5‐year OS was 91.9%, and the CSS was 92.8%) than those who underwent cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) (the 5‐year OS = 83.8%, p = 0.022 and CSS = 84.9%, p = 0.038).ConclusionsSurgery remains the gold standard for treating T2N0M0 glottic LSCC patients because it can achieve satisfactory oncological outcomes. Regarding the systemic conditions, the effect of partial laryngectomy is similar to that of total laryngectomy. Moreover, partial laryngectomy preserves the function of the larynx. VPL may be superior to CHP/CHEP, depending upon the invasiveness of the tumor.

258 Radiotherapy in the Treatment of Early-Stage Glottic Laryngeal Carcinoma - Experience from a Hospital Center

258 Radiotherapy in the Treatment of Early-Stage Glottic Laryngeal Carcinoma - Experience from a Hospital Center

ALCAM is a biomarker of tumor aggressiveness and worse prognosis in glottic laryngeal squamous cell carcinoma.

Laryngeal squamous cell carcinoma (LSCC) is the second most frequent head and neck tumor. Prognosis of patients with LSCC has not improved in recent decades, showing a need for the identification of prognostic biomarkers and new therapeutic targets. Recently, we showed that ALCAM overexpression was associated with glottic LSCC prognosis. Aiming to validate the prognostic value of ALCAM, we evaluate the ALCAM protein levels by immunohistochemistry in 263 glottic LSCC surgically treated with neck dissection. ALCAM was expressed in 48.7% and overexpressed in 36.5% of glottic LSCC samples. ALCAM overexpression was associated with lymph node metastasis (p = 0.030), lymphovascular involvement (p = 0.0002), high-grade tumors (p = 0.025), and tumor relapse (p = 0.043). Multivariate survival analyses showed an overfitting between ALCAM overexpression and lymph node metastasis as a prognostic variable. High ALCAM expression was associated with an aggressive glottic LSCC profile.

Impacts of Postoperative Enteral Nutrition and Rosiglitazone on Quality of Life Together with Prognosis of Patients with Early-Stage Glottic Laryngeal Carcinoma

We aimed to clarify the influence of postoperative enteral nutrition and rosiglitazone on the quality of life and prognosis of patients with early stage glottic laryngeal carcinoma. Low-temperature plasma radiofrequency ablation was performed in the control group, while the observation group additionally received rosiglitazone and postoperative enteral nutrition. After therapy, the observation group had lower fundamental frequency perturbation and amplitude perturbation and higher harmonic-to-noise ratio and effective rate than the control group. One month after treatment, the serum levels of albumin, prealbumin, and hemoglobin in the observation group were higher than those in the control group. Moreover, peripheral blood immune markers, CD3+, CD4+, and CD4+/CD8+ levels were higher in the observation group, while CD8+ levels were lower. The incidence rate of adverse reactions was lower in the observation group than in the control group. The five-year survival rates were 77.14% (27/35) and 54.29 % (19/35) in the observation and control groups, respectively. Postoperative enteral nutrition and rosiglitazone can prolong survival, improve immune function and quality of life in patients with early-stage glottic laryngeal carcinoma, and reduce adverse reactions during treatment, which is an ideal treatment plan.

Programmed death-ligand 1 and tumor-infiltrating lymphocytes (TILs) – low TIL density may predict poorer long-term prognosis in T1 laryngeal cancer

We evaluated the prognostic role of programmed death-ligand 1 (PD-L1) and tumor-infiltrating lymphocytes (TILs) in T1 glottic laryngeal squamous cell carcinoma (LSCC). T1 glottic LSCC patients (n = 174) treated at five Finnish university hospitals between 2003 and 2013 were included. Tissue microarray (TMA) blocks were used for PD-L1 immunohistochemistry. TILs were scored from intratumoral and stromal regions in whole tissue sections. Of 174 patients, 92 (53%) had negative, 66 (38%) intermediate, and 16 (9%) high PD-L1 levels. Of 80 patients whose TILs were analyzed, 50 (63%) had low and 30 (38%) high stromal TIL density. Patients with a local recurrence or a new primary tumor of the larynx had lower TIL density than had other patients (p = 0.047). High PD-L1 expression with low stromal TIL density was associated with inferior 5-year disease-specific survival (85% vs. 100%, p = 0.02). In conclusion, in patients treated for T1 glottic LSCC, low stromal TIL density was associated with local recurrences and new primary tumors of the larynx. High PD-L1 expression with low stromal TIL density may be associated with worse survival in T1 glottic LSCC.

Treatment Outcome of Early-stage Laryngeal Carcinoma Treated with Radical Radiotherapy Using Different Techniques: A Retrospective Study

Aim: The aim was to evaluate the treatment outcomes and prognostic characteristics of patients with early-stage glottic laryngeal carcinoma who underwent radical radiotherapy (RT) with different techniques.Materials and Methods: Radiotherapy was applied using the 2D conventional technique, 3DCRT (three dimensional conformal radiotherapy and IMRT (intensity modulated radiation therapy). Clinical T stages were 12 (48%) for T1a, 5 (20%) for T1b and 8 (32%) for T2. Stage and anterior commissure involvement were analyzed as prognostic factors. Results: There were 12 (48%) patients with T1a, 5 (20%) patients with T1b and 8 (32%) patients with T2 cancer. 5 years of overall survival and diseases free survival for T1a, T1b, T2 were found to be 91%, 80%, 62% and 91%, 80%, 62% respectively. 5 year survival for patients without and with involvement of anterior commissure was 92% and 67% respectively. Hence, showing poor survival in patients with T2 lesion or T1 lesion with involvement of anterior commissure. Conclusion: In early-stage laryngeal carcinomas, radical RT is a function sparing and effective treatment modality with excellent survival rates, regardless of treatment techniques.

Clinical Application of the Residual Thyroid Cartilage for Laryngeal Function Reconstruction in the Partial Laryngectomy-A Single Center Experience.

To investigate the outcomes of using the residual thyroid cartilage for laryngeal function reconstruction in early glottic laryngeal carcinoma. From March 2017 to June 2022, 21 patients with glottic carcinoma who underwent laryngeal function reconstruction were analyzed retrospectively. The operation was performed under general anesthesia. Reconstruction of ipsilateral hemilarynx defect by downward movement of ipsilateral residual thyroid cartilage plate. During the follow-up period, the laryngeal function and tumor recurrence were evaluated. otally 20 male patients and 1 female patient were enrolled in this study. Of the 20 initial primary tumors, there were 6 patients with T1N0M0 stage, 12 ones with T2N0M0 stage, 1 with T1N1M0 stage, 1 with T3N0M0 stage, and 1 with T2N1M0 stage. The patient with recurrent tumor was T3N1M0 stage. The follow-up time ranged from 9 to 63months. All patients were healed by first intention after surgery. All patients without laryngeal stenosis were removed from tracheotomy tube. So far, all patients have good laryngeal function. One patient relapsed at the last follow-up. It is safe to repair hemilarynx defect with residual thyroid cartilage plate on the affected side, and it is an important choice for laryngeal function reconstruction after vertical partial laryngectomy.

Predictive value of pathological carcinoma size in patients with T2 glottic laryngeal squamous cell carcinoma

Background T2N0M0 glottic laryngeal squamous cell carcinoma (LSCC) is a common type of laryngeal cancer. Objectives The objective of this research was to assess the predictive value of tumor size for the rates of overall survival (OS) and disease-free survival (DFS) as determined by postoperative pathological examination in patients with T2 LSCC. Methods A retrospective study was conducted on 535 successive patients with T2 glottic LSCC who underwent operation from 2005 to 2010. The effect of tumor size on OS and DFS results was evaluated by the affected area. Results Of the cohort, 528 (98.7%) were male, and 7 (1.3%) were female, with an average age of 60.1 ± 9.4 years. The 10-year DFS and OS rates were 72.1% and 76.3%, respectively. The tumor diameter and area cut-off values that best discriminated OS and DFS rates were 1.35 cm and 1 cm2, respectively. Patients with glottis carcinoma with a longer tumor diameter and larger tumor area had inferior OS and DFS rates. Tumor diameter and tumor area were independent predictive factors for the rates of OS and DFS in patients with T2 glottic LSCC. Conclusion and significance This research showed that patients with T2 glottic LSCC with a carcinoma diameter >1.35 cm or a tumor area >1 cm2 have worse survival outcomes. These factors independently predict survival outcomes in patients.

Effect of different surgical modalities on swallowing-related quality of life in patients with glottic laryngeal squamous cell carcinoma: how should we choose?

Effect of different surgical modalities on swallowing-related quality of life in patients with glottic laryngeal squamous cell carcinoma: how should we choose?

Effect of CO2 laser combined with low-temperature plasma radiofrequency ablation on the early glottic laryngeal carcinoma

ObjectiveTo explore the effect of CO2 laser combined with low-temperature plasma radiofrequency ablation on the early glottic laryngeal carcinoma. Methods70 patients with early glottic laryngeal carcinoma were enrolled in this retrospective study. The patients (40 cases) in the control group were treated by CO2 laser. The patients in the combination group (30 cases) were treated by CO2 laser combined with low-temperature plasma radiofrequency ablation. ResultsThe postoperative recurrence rate in the combination group was notably decreased than the control group (P < 0.05). There were 2 patients with postoperative bleeding, 3 with vocal cord adhesion, and one with dyspnea in the combination group. Similarly, there were 3 patients with postoperative bleeding, 5 with vocal cord adhesion, and 1 with dyspnea in the control group. ConclusionCO2 laser combined with low-temperature plasma radiofrequency ablation has a low postoperative recurrence rate in the treatment of the early glottic laryngeal carcinoma.

Survival outcomes in patients with T3-4aN0M0 glottic laryngeal squamous cell carcinoma and evaluation of postoperative radiotherapy.

This study aimed to evaluate the clinical outcomes of patients with T3-4aN0M0 glottic laryngeal squamous cell carcinoma (LSCC) treated with laryngectomy, and to assess the postoperative radiotherapy (PORT) results in terms of the survival of T3-T4aN0M0 patients with negative margins. This was a retrospective review of 369 T3-4aN0M0 glottic LSCC cases. The 5-year cancer-specific survival (CSS) and overall survival (OS) rates were 67.5 and 66.7%, respectively. Patients who received total laryngectomy had worse survival [5-year CSS, 62.5%; disease-free survival (DFS), 56.2%] than those who underwent partial laryngectomy (5-year CSS, 79.3%; DFS, 65.4%). More advanced-stage cancer is a predictor of poor survival. There was no significant difference in CSS or DFS between patients with positive margins following rescue therapy and those with negative margins. Furthermore, no difference in the survival rates was observed between patients with negative margins who received PORT and those who did not (5-year DFS: 59.1 vs. 63.8%, P=0.057 and CSS: 62.5 vs. 69.5%, P=0.074). For T3-4aN0M0 glottic LSCC patients, surgical treatment remained a good option, as it can achieve satisfactory oncological outcomes. However, PORT did not increase survival in surgically managed pT3-4aN0M0 LSCC patients with negative margins.

Bioradiotherapy with Cetuximab May Reduce the Risk of Neck Node Relapse in Locoregionally Advanced Laryngeal Glottic Carcinoma: May HER1-Profile Be Useful in the Bioselection of Patients?

The aim of the study was to evaluate survival in patients with advanced glottic laryngeal squamous cell carcinoma treated by bioradiotherapy (BioRT) with cetuximab and eventual salvage surgery (group A, n = 66) or upfront surgery (total laryngectomy or near-total laryngectomy) with or without postoperative radiotherapy (PORT) (group B, n = 66). The predictive role of HER1 expression in the bioselection of tumors was evaluated. Relapse-free (RFS), metastasis-free (MFS), overall (OS) survivals, salvageability, and rates of larynx preservation were analyzed. The two groups were balanced by propensity score method on their baseline characteristics. No significant differences in RFS and OS were found, while MFS results were significantly higher in group A (p = 0.04). Group A showed a 22% reduction in the probability of nodal metastasis (p = 0.0023), mostly in tumors with higher HER1 expression. The salvageability with TL at 3 years was 54% after prior BioRT and 18% after prior upfront NTL (p < 0.05). BioRT with cetuximab showed a reduction in the risk of lymph node relapse, particularly in the case of HER1 positive tumors, and it allowed to achieve a higher rate of functional larynx preservation and a higher salvageability compared with upfront surgery. HER1 analysis could be clinically useful in the bioselection of tumors that may benefit from BioRT with cetuximab, particularly in those with neck node metastatic propensity.

Paraglottic Space Invasion in Glottic Laryngeal Cancer: A Clinical-Pathological Study.

This study aims to prospectively compare endoscopic, radiological, and pathological features of a cohort of patients with glottic laryngeal squamous cell carcinoma (LSCC) undergoing open partial horizontal laryngectomy (OPHL) type II/III or total laryngectomy to better understand the reliability of preoperative endoscopy and computed tomography (CT) to predict the inferior paraglottic space (iPGS) involvement. We prospectively compared the endoscopic, radiological, and pathological findings in patients with glottic LSCC who underwent OPHL II/III, or total laryngectomy. Endoscopy achieved a diagnostic accuracy of 87.2% for the anterior iPGS (iPGSa) and 86.1% for the posterior iPGS (iPGSp). There was no statistically significant difference in terms of histopathologic iPGSa involvement between reduced (85%-17/20 pts) and absent (92%-24/26 pts) vocal cord mobility (p=0.39). CT alone did not improve the diagnostic performance of the endoscopy, reaching a diagnostic accuracy of 62.9% and 73.7% for the iPGSa and iPGSp, respectively. When endoscopy and CT were combined, the diagnostic performance improved for the iPGSp, achieving a sensitivity (Se), specificity (Spe), positive predictive value (PPV), and negative predictive value (NPV) of 100%, 89.8%, 68.7%, and 100%, respectively. On the contrary, the combination of CT and endoscopy improved only the Se and NPV for the iPGSa with respect to the sole endoscopic assessment. Whenever motility impairment is present, a histopathologic invasion of the iPGS should be suspected. Endoscopic assessment of laryngeal motility achieved a satisfactory value of Se, Spe, PPV, and NPV in predicting the involvement of the iPGS. CT scan is still the mainstay imaging technique in the clinical staging of patients with LSCC. 4 Laryngoscope, 133:1184-1190, 2023.

Meta-Analysis of Low Temperature Plasma Radiofrequency Ablation and CO2 Laser Surgery on Early Glottic Laryngeal Carcinoma.

Objective Meta-analysis is used to analyze the treatment of early glottic laryngeal carcinoma by cryogenic plasma radiofrequency ablation combined with CO2 laser surgery. Methods Retrieval of PubMed, Embase, Medline, VIP, Wanfang, and CNKI databases using a computer. The retrieval period is from the creation of the database until August 31, 2021. References to the included literature were also searched at the same time. According to the inclusion and exclusion criteria, literatures are screened independently, relevant data were extracted, and meta-analysis was conducted. Results Recurrence rates are reported in seven literatures. In interstudy heterogeneity test: P = 0.624, I2 = 0%, fixed effect model analysis shows that there is no significant difference in recurrence rate between low temperature plasma radiofrequency ablation and CO2 laser ablation (OR = 0.80, 95% CI (0.35, 1.29), P = 0.371). Intraoperative blood loss is reported in 5 literatures, and heterogeneity test of each study is as follows: P = 0.03, I2 = 67%. Low temperature plasma radiofrequency ablation results in more intraoperative blood loss than CO2 laser ablation (SMD = −0.71, 95% CI (0.08, 0.82), P = 0.01). There are five reports on postoperative pain in two treatments: P = 0.04, I2 = 64%. There is no significant difference in postoperative pain between low temperature plasma radiofrequency ablation and CO2 laser ablation (SMD = −0.21, 95% CI (-0.44, 0.10), P = 0.134). Operative time is reported in nine articles: P < 0.01, I2 = 95%. The operative time of low temperature plasma radiofrequency ablation is significantly shorter than CO2 laser ablation (SMD = −2.38, 95% CI (-3.91, -1.62), P < 0.01). There are two reports on postoperative mucosal recovery: P = 0.328, I2 = 2%. Low temperature plasma radiofrequency ablation was significantly better than CO2 laser ablation in postoperative mucosal recovery (OR = 5.49, 95% CI (2.36, 10.18), P < 0.01). Conclusion Low temperature plasma radiofrequency ablation is superior to CO2 laser surgery in the treatment of early glottic laryngeal carcinoma in terms of operative time and postoperative mucosal recovery. Low-temperature plasma radiofrequency ablation, on the other hand, results in higher intraoperative blood loss, with no discernible difference in recurrence rate or postoperative pain severity between the two treatments.

Comparison of Partial Laryngectomy Versus Radiotherapy for the Treatment of Early Glottic Carcinoma: Complications and Oncological Results: A Nonrandomized Clinical Trial

The aim of this non-randomized clinical trial was to evaluate tumor outcomes and subjective quality of voice following radiotherapy and partial laryngectomy in early-stage glottic laryngeal cancers. Non-Randomized Clinical Trial. Otolaryngology and radiation oncology clinics of Imam Khomeini (an affiliated hospital of Tehran University of Medical Sciences) and Amir Aalam Hospitals. Fifteen patients with early-stage glottic laryngeal carcinoma were admitted to the otolaryngology clinic, divided into two treatment groups: radiotherapy and partial laryngectomy. Of the total 50 patients, 25 had a partial laryngectomy and 25 radiotherapies. The comparison of the average of the Voice Handicap Index (VHI) showed significant improvement of vocal quality after treatment for both partial laryngectomy and radiotherapy (P&lt;0.0001 for both). But there was no significant difference in VHI mean scores between the two treatment groups (patients treated by partial laryngectomy and radiotherapy). Short- and long-term complication was higher in patients undergoing surgery than radiotherapy group (P&lt;0.0001). With regard to oncological outcome after one and eight-year after treatment, no differences were observed in the two treatment groups; there was a significant relationship between smoking cessation and recurrence of disease in the partial laryngectomy treatment group (P=0.012). There was no significant difference in voice quality and life expectancy of patients operated on using open surgery and patients treated with radiotherapy in this series. Open surgery may have more noticeable complications than radiotherapy.

Survival and Larynx Preservation in Early Glottic Cancer: A Randomized Trial Comparing Laser Surgery and Radiation Therapy

The prognosis of glottic T1a laryngeal squamous cell carcinoma (LSCC) is excellent with both transoral laser surgery (TLS) and radiation therapy (RT). Our aim was to compare TLS and RT treatment results in a randomized study. Of 56 male patients with glottic T1a LSCC, 31 were randomized for TLS and 25 for RT. Survival and larynx preservation data were collected from medical records. Five-year overall survival (OS) was 87%, disease-specific survival (DSS) was 97%, and recurrence-free survival (RFS) was 81% in patients treated with TLS. Five-year OS was 92%, DSS was 100%, and RFS was 88% in patients treated with RT. The primary treatment method was not associated with OS, RFS, or DSS in a log-rank test. The larynx preservation rate was similar in both groups (TLS, 97%; RT, 92%; P=.575). In a prospective randomized setting oncological outcomes of both treatment modalities (TLS or RT) for T1a LSCC were similar.

Oncological Outcomes of Transoral Laryngeal Microsurgery with Fiber-Optic Diode Laser for Early Glottic Cancer: A Single-Center Experience

Backgroud/Objectives: Transoral laser laryngeal microsurgery (_LTLM) has been widely used in the treatment of early-stage glottic laryngeal squamous cell carcinoma (LSCC) for the past few decades. Although T stage, tumor grade, anterior commissure involvement, type of cordectomy, positive surgical margin, and postoperative additional therapies were accused as the prognostic factors for recurrence, there is still controversy about these data in the literature. The purpose of this study was to evaluate the oncological results of our patients with early glottic LSCC treated with _LTLM as a single-modality therapy in a single-center study. Methods: Patients with early-stage (T_is-1–2/N₀) glottic LSCC who underwent _LTLM as a primary treatment from 2011 to 2019 were retrospectively reviewed. The clinicopathological factors and oncologic outcomes were analyzed. Results: One hundred and sixty-one patients were enrolled in this study. The 5-year overall (OS), disease-specific (DSS), disease-free (DFS), and laryngectomy-free survival rates were 84.5%, 97.9%, 79.2%, and 93.5%, respectively. The most common stage, histopathological type, and type of endoscopic cordectomy were T₁ stage, well-differentiated cancer, and type 2 cordectomy, respectively. A positive surgical margin was defined in 20 (12.4%) patients. There was a significant relationship between histopathological grade and positive surgical margins (p = 0.038). OS and DSS rates of “wait and see” modality were lower, while DFS of radiotherapy was lower than that of other treatment modalities in patients with positive surgical margins, but the differences were not statistically significant. Nineteen (11.8%) patients had a recurrence. DSS was statistically significantly lower in patients with recurrence (p < 0.001). Conclusion: The results of our study showed that anterior commissure involvement, surgical margin positivity, and higher T stage statistically did not reduce survival rates in early-stage LSCC patients treated with _LTLM. As the histopathological grade of the tumor worsens, the risk of surgical margin positivity increases. RT may have a negative effect on recurrence and organ preservation in the additional treatment of patient with positive surgical margins.

T1 glottic laryngeal cancer: the role of routine follow-up visits in detecting local recurrence

PurposeWe assessed the treatment outcome and the benefits of routine follow-up visits in T1 glottic laryngeal squamous cell carcinoma (LSCC).MethodsMedical records of patients diagnosed with stage T1 glottic LSCC (N = 303) in five Finnish university hospitals between 2003 and 2015 were reviewed. Moreover, data from the Finnish Cancer Registry and the Population Register Center were collected.ResultsOf all 38 recurrences, 26 (68%) were detected during a routine follow-up visit, and over half (21 of 38, 55%) presented without new symptoms. Primary treatment method (surgery vs. radiotherapy) was not connected with 5-year disease-specific survival (DSS) or laryngeal preservation rate.ConclusionThe majority of recurrences were detected on a routine follow-up visit, and local recurrences often presented without new symptoms. Routine post-treatment follow-up of T1 glottic LSCC seems beneficial.Trial registrationTrial registration number and date of registration HUS/356/2017 11.12.2017.