[The pT-classification of primary vocal cord carcinomas and its significance for T-classification]

Since the pretherapeutic T and pT classification of vocal cord cancer according to the UICC has often been found to fail in a high percentage of cases, frequently resulting in an insufficient separation of the different T categories, the pT classification proposed by Glanz was applied in order to obtain a more exact and better reproducible pretreatment system. In a histopathological investigation of 223 previously untreated carcinomas of the vocal cord dating from 1978 to 1988, specimens from total and partial laryngectomies were examined by subserial sectionings. The extension of each lesion was ascertained by measuring tumor in three dimensions per millimeter and determining affected histopathological structures. Neck lymph nodes were also examined for metastases. The different tumor stages were then evaluated with the UICC T/pT classification of Glanz's pT classification. The survival rates and recurrence-free rates of both classification systems were compared. Our evaluation showed that 24% of all the vocal cord cancers studied had to be classified to a higher tumor stage. The pT classification developed by Glanz was better able to separate the different tumor categories than the UICC T/pT classification. Glanz's pT classification system, staging a glottic cancer according to its exact size and laryngeal structures involved, is a significant improvement on the UICC T and pT classification used to date.