[Anterior commissure in the spreading of the glottic cancer: classification, prognosis and therapy]

Laryngeal tumors involving anterior commissure have a particularly aggressive behaviour. Prognosis and therapy of these tumors is quite different depending on the type and the extension of commissural involvement. In spite of these considerations, present TNM classifications (UICC/AJCC) of laryngeal tumors do not consider anterior commissure in the spreading of glottic cancer. To obviate this problem, Fini-Storchi (1993) proposed an anatomic-oncological definition of anterior commissure (AC) and, on it, a classification (additional to TNM system) of AC involvement (AC1-AC2-AC3). We marginally modified Fini-Storchi classificative criteria and, according to them, we performed e re-classification of laryngeal tumors with anterior commissure involvement, we observed in our Department between 1977 and 1991 (255 cases). In particular we treated 190 AC1 (74.5%), 40 AC2 (15.6%), 25 AC3 (9.8%). For each AC category, different therapeutical options are presented and discussed. Long term results (minimum follow-up: 38 months) are evaluated and efficacy of AC classification is checked.