medigraphic.com
Órgano Oficial del Hospital Angeles Health System

2012, Number 1

Next >>

Acta Med 2012; 10 (1)

Cord and cordarytenoid fixation in laryngeal cancer. Same stage, different outcome

Gallegos HJF

Language: Spanish
References: 18
Page: 5-8
PDF size: 270.05 Kb.


ABSTRACT

Introduction: In glottic cancer, cord fixation and cord-arytenoid fixation are staged as T3, but patients with cord-aritenoyd immobility have poor outcome compared with the first due to increased neoclassic infiltration in the laryngeal structure; the fixing of both glotic structures means massive infiltration of the para-glotic space. The purpose of this paper is to know if there are some difference between patients with cordal fixation and cord and arytenoid fixation. Material y methods: Retrospective analysis of a series of patients with SCCL. Variables analyzed: T-staging, tumor site, and arytenoid-mobility/fixation. These were correlated with histopathological node status. Statistical significance was evaluated with χ2 test. Results: Ninety-one patients included, 82 males and 9 females; median age of 66 years. The most frequently affected site: glottic-subglottic region (38) followed by glottis (22). The most frequent T stage was T3 (46%) followed by T4 (25%); 81% were N0 and 19% N+. 76 (83%) had arytenoid fixation. Factors associated with CNM were glottic-supraglottic infiltration (65%) and arytenoid fixation (17 vs 0%, p = 0.048). None of the patients with arytenoid mobility had CNM. Tumor infiltration to thyroid gland was demonstrated in 14%. The most important risk factor was subglottic extension (17%; p = 0.5). Conclusions: Arytenoid-cord fixing is associated with increased chance of lymph node metastases and probably worse prognosis compared with patients with only cord immobility.


REFERENCES

  1. Gallegos-Hernández JF, Martínez-Gómez H, Flores-Díaz R. La disección radical de cuello en el cáncer de vías aéreo-digestivas superiores (VADS). Indicaciones, extensión y radicalidad. Cir Ciruj 2002; 70: 369-376.

  2. Andersen P, Cambronero F, Shaha AR, Shah JP. The extent of neck disease alter regional failure Turing observation of N0 neck. Am J Surg 1996; 172: 689-691.

  3. Lefebvre JL, Buisset E, Coche-Dequeant B, Van JT, Prevost B, Hecquet B et al. Epilarynx: pharynx or larynx. Head Neck 1995; 17(5): 377-381.

  4. Yüce I, Cağlı S, Bayram A, Güney E. Occult metastases from T1-2 supraglottic carcinoma: role of primary tumor localization. Eur Arch Otorhinolaryngol 2009; 266: 1301-1304.

  5. Robbins KT, Shaha AR, Medina JE, Califano JA, Wolf GT, Ferlito A. Consensus statement on the classification and terminology of neck dissection. Arch Otolaryngol Head and Neck Surg 2008; 134: 536-538.

  6. Genden EM, Ferlito A, Rinaldo A, Silver CE, Fagan JJ, Suárez C. Recent changes in the treatment of patients with advanced laryngeal cancer. Head Neck 2008; 30: 103-110.

  7. Hagikyan ND, Bastian RW. Surgical therapy of glottic and subglottic tumors. In: Tawley SE, Panje WR, Batsakis JG, Lindberg RD editors. Comprehensive management of head and neck tumors. Phyladelphia: Saunders Co., 1999: 1039-1068.

  8. National Comprehensive Cancer Network. Clinical practice guidelines in Oncologytm. Head&Neck Cancers. Laryngeal Cancer 2010; 2011.

  9. American Joint Committee on Cancer (AJCC). Cancer Staging Manual. TNM Staging system for the larynx. V.2.2008. Sixth edition, 2002.

  10. Ganly I, Patel SG, Matsuo J, Sing B, Kraus DH, Boyle J et al. Predictor of outcome for advanced-stage supraglottic laryngeal cancer. Head and Neck 2009; 31: 1489-1495.

  11. Zhang B, Xu ZG, Tang PZ. Elective lateral neck dissection for laryngeal cancer in the clinically negative neck. J Surg Oncol 2006; 93: 464-467.

  12. Reidenbach MM. Topographical anatomy and oncologic implications of the anterolateral surface of the arytenoid cartilage. Eur Arch Otorhinolaringol 1998; 255: 140-142.

  13. Reidenbach MM. The attachements of the conus elasticus to the laryngeal skeleton; physiologic and clinical implications. Clin Anat 1996; 9: 363-370.

  14. Kirchner JA. Two hundred laryngeal cancers; patterns of growth and spread as seen in serial sections. Laryngoscope 1977; 87: 474-482.

  15. Wang RC. Three-dimensional analysis of cricoarytenoid joint motion. Laryngoscope 1998; 108: 1-17.

  16. Hirano M, Kurita S, Matsuoka H, Tateishi M. Vocal fold fixation in laryngeal carcinomas. Acta Otolaryngol 1991; 111: 449-454.

  17. Dagan, Morris CG, Bennett JA, Mancuso AA, Amdur RJ Hinerman RW et al. Prognostic significance of paraglottic space invasion in T2N0 carcinoma. Am J Clin Oncol 2007; 30: 186-190.

  18. Gallegos HJF. Tratamiento actual del cáncer de laringe. Acta Med 2008; 6: 154-157.




2020     |     www.medigraphic.com