Original Article

Vol. 47 No. 3 (2023): Cerrahpaşa Medical Journal

Does Anterior Commissure Involvement Change the Selection of Treatment Modality in Early-Stage Glottic Larynx Cancer?

Main Article Content

Chinara Aliyeva
Meltem Dağdelen
Haydar Murat Yener
Muhammed Veysel Hekim
Merve Şahin
Fırat Tevetoğlu
Sinem Kara Peker
Yetkin Zeki Yılmaz
Emine Deniz Gözen
Emin Karaman
Günay Can
Ömer Erol Uzel

Abstract

Objective: Glottic laryngeal cancers are detected at an early stage at the time of diagnosis. Radiotherapy or transoral laser microsurgery as a local treatment is a choice for early-stage glottic laryngeal cancer. This study aims to investigate the local control rate after radiotherapy or transoral laser microsurgery for early-stage glottic laryngeal cancer with anterior commissure involvement.



Methods: In total, 119 patients with early-stage (Tis-T1-2) laryngeal cancer were treated in our institution with radiotherapy or transoral laser microsurgery between 2009 and 2021. The median follow-up time was 52 months. Seventy-three patients underwent transoral laser microsurgery. Forty-six patients received radiotherapy, and there were 41 patients with anterior commissure involvement.



Results: The 2 and 5 years overall survival rates were 92% and 73%, whereas local failure-free survival rates were 84% and 82% in all groups, respectively. The 2-year overall survival was 88% in the radiotherapy arm and 94% in the transoral laser microsurgery arm, respectively. There was no statistically significant difference between the two treatment groups for overall survival (P: .062). According to anterior commissure involvement, 29 underwent transoral laser microsurgery, whereas 12 patients received radiotherapy. A total of 9 local failures occurred in the transoral laser microsurgery group, there was no recurrence in the radiotherapy group (P: 0.028).



Conclusion: There was no statistically significant difference between the two treatment groups for local failure-free survival and overall survival. However, in the case of the anterior commissure involvement, 9 local failures occurred in the transoral laser microsurgery group, and there was no recurrence in the radiotherapy group. Radiotherapy might be recommended in early-stage glottic laryngeal cancer, especially in patients with anterior commissure involvement.



Cite this article as: Dağdelen M, Yener HM, Hekim MV, et al. Does anterior commissure involvement change the selection of treatment modality in early-stage glottic larynx cancer? Cerrahpaşa Med J. 2023;47(3):285-290.


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