[Histopathologic study of the frontolateral laryngectomy specimen: topics of clinical interest].
Frontolateral laryngectomy is a surgical procedure that allows removal of a vocal cord, anterior commissure, one third of the healthy vocal cord and the thyroid cartilage keel. It is indicated in patients with T1a and T1b glottic-located carcinomas with adverse prognosis factors and selected T2 cases. The success relies on appropriate tumor excision. In order to make an assessment, we need to know the critical topics of clinic interest in the histopathologic study of the specimen. The objective is to analyze which are the significant factors to histologically assess in frontolateral laryngectomy and to report the histological study technique conducted at the Oncology Hospital of the National Medical Center of the Mexican Social Security Institute. According to the critical sites in the surgical technique and significant for local tumor recurrence, we report the histological study technique followed for the frontolateral laryngectomy specimens. The factors to assess in the frontolateral laryngectomy specimen are the anterior third part of the healthy cord, the paraglottic space and the crico-vocal ligament. The pathologic study technique reported herein allows us to satisfactorily assess these risk factors. Macroscopic tumor excision is not sufficient, and a satisfactory histological analysis is required that will allow us to assess the critical sites where there may be residual tumor. These may translate into a higher possibility of tumor recurrence for the patient. Communication between pathologists and surgeons is essential to achieve success in this procedure.
Mantilla-Morales
Alejandra
A
Departamento de Anatomía Patológica, Hospital de Oncología, Centro Médico Nacional Siglo XXI, IMSS.
Gallegos-Hernández
José Francisco
JF
Posada-Sibaja
Axel
A
D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*