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Stage II glottic carcinoma: Prognostic factors and management
Author(s) -
Kaplan Michael J.,
Johns Michael E.,
Mclean W. Copley,
Slaughter G. FITZHUGH,
Clark David A.,
Boyd James C.,
Cantrell Robert W.
Publication year - 1983
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-198306000-00005
Subject(s) - medicine , stage (stratigraphy) , glottis , carcinoma , oncology , radiology , surgery , larynx , geology , paleontology
Three hundred thirty‐six patients with squamous cell carcinoma of the glottic larynx treated at the University of Virginia Medical Center from 1960 through 1977 were reviewed. Seventy patients with T2N0M0 disease, grouped according to the criteria of the American Joint Committee on Cancer, 1978, form the basis of this report. The 5‐year actuarial survivals, recurrences, salvages, and prognostic factors were examined. Treatment was radiation, surgery, or a combination of radiation and surgery. Impaired vocal cord mobility in Stage II glottic squamous cell carcinoma is the crucial significant prognostic factor in predicting response to therapy, survival, and response to salvage therapy for recurrences. The 90% 5‐year recurrence‐free rate with freely mobile cords is comparable to that achieved with Stage I lesions. Impaired mobility resulted in a 5‐year recurrence‐free rate of 73%, which is comparable to that of T3N0 lesions. We support the concept of reclassifying Stage II disease into Stage Ha (mobile cords) and Stage IIb (impaired mobility). Based on this review and those reported in the literature, we recommend radiation therapy for Stage IIa disease. Surgery results in fewer recurrences and in longer survival than irradiation when the vocal cords are not freely mobile (Stage IIb).