Clinico-pathological correlation of T3 glottic carcinomas

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Oncology

Background:

• The optimal treatment for T3 glottic carcinoma, whether radiotherapy or laryngectomy, remains debated.
• Accurate staging is crucial for effective treatment planning in laryngeal cancer.

Purpose of the Study:

• To evaluate the incidence and predictors of clinical understaging in T3 glottic carcinoma patients treated with total laryngectomy.
• To assess the impact of clinical staging on treatment selection for glottic cancer.

Main Methods:

• Retrospective analysis of 82 patients with non-irradiated T3 glottic carcinomas undergoing total laryngectomy.
• Correlation of clinical T-stage with pathological T-stage (pT4), identifying factors associated with understaging.

Main Results:

• 45% of patients were clinically understaged, with a final pathological stage of pT4.
• Subglottic extension and the presence of a tracheostomy were significantly associated with understaging.
• A trend towards understaging anterior commissure tumors was observed.

Conclusions:

• Clinical staging accuracy is a concern for T3 glottic carcinoma, with significant understaging rates.
• Subglottic extension and tracheostomy are key indicators for potential understaging, favoring laryngectomy.
• Radiotherapy for T3 glottic carcinoma requires careful consideration of understaging risks, especially for anterior commissure tumors.