title: Implications of cartilage invasion in surgically treated laryngeal carcinoma.
abstract: BACKGROUND
  Cartilage invasion adversely affects the outcome of laryngeal carcinoma treated with radiotherapy. The UICC and American Joint Committee on Cancer (AJCC) classify laryngeal carcinoma with cartilage invasion as T4 or stage IV.
  
  
  METHODS
  This study examines the prognostic significance of cartilage involvement in T3,4 N0,1 glottic carcinoma treated with total laryngectomy. Patients with tumor extension to pharynx, tongue, and thyroid gland, extracapsular spread, positive resection margins, and less than 2 years' follow-up were excluded.
  
  
  RESULTS
  Sixty-seven pT3 (cartilage free of tumor) and 37 pT4 (cartilage invaded by tumor) cases were studied. The difference between the pT3 and pT4 groups in terms of local or regional recurrence, distant metastasis, and determinate survival was not significant.
  
  
  CONCLUSIONS
  The results of this study question the use of cartilage invasion as a staging parameter for surgically treated laryngeal carcinoma. However, further studies with larger sample sizes are required to fully elucidate the prognostic significance, if any, of cartilage invasion in surgically treated cancer of the larynx.
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Fagan
authors.forename: F
authors.initials: F
authors.lastname: D'Amico
authors.forename: R L
authors.initials: RL
authors.lastname: Wagner
authors.forename: J T
authors.initials: JT
authors.lastname: Johnson
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D016001:Confidence Intervals; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D007825:Laryngectomy; D008297:Male; D009361:Neoplasm Invasiveness; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis