title: Anterior laryngeal commissure: Histopathologic data from supracricoid partial laryngectomy.
abstract: OBJECTIVE
  To analyze histopathologic invasion of the anterior laryngeal commissure on surgical specimens from patients operated on for stage-2 squamous-cell carcinoma managed by supracricoid partial laryngectomy (SCL).
  
  
  METHODS
  Twenty-five patients with previously untreated stage-2 squamous-cell carcinoma were selected. Preoperative endoscopy confirmed anterior commissure involvement; CT found no cartilage lysis. SCL was performed in all cases: 15 anterior frontal SCLs with epiglottoplasty, 8 with cricohyoidepiglottopexy, and 2 with cricohyoidopexy. Histopathology analyzed resection margins (< 1 mm, 1-5 mm, > 5 mm), cartilage extension and vascular embolism. Mean time to observation was 18 months (range, 12-36 months).
  
  
  RESULTS
  Resection margins were < 1 mm in 7 cases (28%), 1-5 mm in 9 and > 5 mm in 9 patients. Vascular emboli were found in 15 patients (60%). Twenty patients were free of medial thyroid cartilage involvement; 5 showed cartilage extension (20%), restricted to the internal cortical layer in 4 cases (stage T3) and transfixing in 1 (stage T4a). Mucosal extension appeared non-predictive of cartilage invasion. The T4a patient showed local laryngeal recurrence at 12 months.
  
  
  CONCLUSIONS
  In laryngeal commissure squamous-cell carcinoma, SCL enables pathologic analysis of the entire anterior commissure as organogenetically defined: medial thyroid wing, in which the three laryngeal regions are inserted. Microscopic cartilage invasion is poorly predicted by mucosal extension, and may affect 20% of initially T2 patients.
authors.affiliation: Service d'ORL et de chirurgie cervicofaciale, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France. Electronic address: jean.michel.prades@univ-st-etienne.com.
authors.forename: J-M
authors.initials: JM
authors.lastname: Prades
authors.affiliation: Service d'ORL et de chirurgie cervicofaciale, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors.forename: M
authors.initials: M
authors.lastname: Gavid
authors.affiliation: Laboratoire d'anatomie et cytologie pathologique, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Dumollard
authors.affiliation: Service d'ORL et de chirurgie cervicofaciale, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors.forename: A-T
authors.initials: AT
authors.lastname: Timoshenko
authors.affiliation: Service d'ORL et de chirurgie cervicofaciale, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors.forename: A
authors.initials: A
authors.lastname: Karkas
authors.affiliation: Laboratoire d'anatomie et cytologie pathologique, hôpital Nord, CHU de Saint-Étienne, 42055 Saint-Étienne cedex 2, France.
authors.forename: M
authors.initials: M
authors.lastname: Peoc'h
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D003413:Cricoid Cartilage / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies
keywords: Anterior commissure of the larynx; Squamous-cell carcinoma; Supracricoid laryngectomy