T3 glottic carcinoma revisited. Transglottic vs pure glottic carcinoma.
OBJECTIVE
To compare results of treatment of patients who have T3 transglottic carcinoma with patients who have T3 pure glottic carcinoma.


METHODS
A retrospective cohort study from January 1976 to December 1990 with a minimum 2-year follow-up.


METHODS
Eye and Ear Hospital, University of Pittsburgh Medical Center.


METHODS
The medical records of 161 patients with T3 glottic carcinoma were reviewed. We excluded 17 patients who were unavailable for follow-up or who had died of other causes but were free of glottic carcinoma. Therefore, 144 patients were entered into this study--79 patients with transglottic carcinoma and 65 with pure glottic carcinoma.


METHODS
Three treatment groups consisted of the following: 30 patients in whom a full course of radiation therapy failed and who subsequently underwent salvage surgery; 92 patients who underwent surgery only; and 22 patients who underwent surgery and had postoperative radiation therapy. Seventy-five patients had total laryngectomy, and 69 had total laryngectomy with neck dissection.


METHODS
Cervical metastasis, extracapsular spread, local failure, stomal recurrence, distant metastasis, and 2 years with no evidence of disease.


RESULTS
Patients with T3 transglottic carcinoma had a higher incidence of occult cervical metastasis (12% vs 9%), overall cervical metastasis (27% vs 17%), and extracapsular spread (43% vs 27%) than did patients with T3 pure glottic carcinoma. Two years of no disease was similar in these two groups (80% vs 79%). Extracapsular spread had a notable effect on distant metastasis and on 2 years of no disease.


CONCLUSIONS
Patients with T3 transglottic carcinoma had a higher incidence of cervical metastasis and extracapsular spread than patients with T3 pure glottic carcinoma. Every patient with T3 transglottic carcinoma should be treated with total laryngectomy with neck dissection.
Hao
S P
SP
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pa.
Myers
E N
EN
Johnson
J T
JT
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies