Histologic characteristics and tumor spread of recurrent glottic carcinoma: analysis on whole-organ sections and comparison with tumor spread of primary glottic carcinomas.
BACKGROUND
The assessment of the precise tumor extent of recurrent glottic carcinomas is a challenge.


METHODS
The histologic characteristics of 29 recurrent glottic carcinomas after radiation failures, initially classified as T1 and T2, were analyzed on whole-organ slices. The growth patterns of 21 recurrent prT3 and prT4 and 52 primary pT3 and pT4 carcinomas were compared.


RESULTS
Fifteen of 29 (52%) recurrent carcinomas were under-staged by imaging studies and endoscopy. Most recurrent carcinomas presented with multicentric tumor foci, whereas most primary carcinomas with a concentric tumor growth pattern (p < .05). Undifferentiated dissociated tumor cells were observed more often in the vicinity of recurrent tumor foci than of the primary tumor mass (p < .05).


CONCLUSIONS
Recurrent glottic carcinomas are often under-staged and present with multiple tumor foci dispersed in different regions of the larynx. If voice-preserving salvage surgery is considered as a treatment option, these facts should be kept in mind.
Zbären
Peter
P
Department of Otolaryngology, Head and Neck Surgery, University of Bern, Inselspital, Bern, Switzerland. peter.zbaeren@insel.ch
Nuyens
Michel
M
Curschmann
Jürgen
J
Stauffer
Edouard
E
D002277:Carcinoma / Q000473:pathology* / Q000628:therapy; D003413:Cricoid Cartilage / Q000473:pathology; D005931:Glottis / Q000473:pathology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000628:therapy; D007823:Laryngeal Nerves / Q000473:pathology; D007825:Laryngectomy; D007828:Laryngoscopy; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D016879:Salvage Therapy; D014057:Tomography, X-Ray Computed