Carcinoma in situ of the glottis: radiotherapy or excision biopsy?
Excision biopsy, radiotherapy, and laryngofissure cordectomy have all been used, but the best treatment regimen for glottic carcinoma in situ remains controversial. A 20-year experience of 37 cases is reported. For the first 10 years biopsy with radiotherapy was the first-line treatment (n = 20), but for the last 10 years surgical or laser excision biopsy alone has been performed (n = 17). The T stage of the carcinoma in situ does not determine its premalignant potential. Malignancy appears to be a recurrence, rather than a new expression of carcinogenesis. Excision biopsy alone provides local control results (75%) comparable to those of primary radiotherapy (85%). Excision biopsy alone, however, retains the option of subsequent radiotherapy with preservation of laryngeal function, but very close follow-up, especially in the first year, is required.
Murty
G E
GE
Department of Otorhinolaryngology, University Hospital, Queen's Medical Centre, Nottingham, England.
Diver
J P
JP
Bradley
P J
PJ
D001706:Biopsy / Q000379:methods; D002278:Carcinoma in Situ / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011882:Radiotherapy, High-Energy; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors