Thyroid cartilage invasion in early-stage squamous cell carcinoma involving the anterior commissure

Abstract

Background: Anterior commissure (AC) carcinoma is in close proximity to the thyroid cartilage. Our objective was to evaluate risk factors for thyroid cartilage invasion.

Methods: This was a retrospective study of tumors involving the AC treated by open surgery. Tumor stage, extensions, vocal fold (VF) mobility, CT scan, and pathologic cartilage status were recorded.

Results: Ninety-four patients with clinical T (cT) classifications cT1b (44%), cT2 (50%), and cT3 (6%) were included. The incidence of thyroid cartilage invasion was 8.5%, significantly related to VF mobility, with invasion in 31% versus 5% with normal mobility (p = .002). Sensitivity, specificity, and positive and negative predictive values for decreased VF mobility were 50%, 90%, 31%, and 95%, respectively. After a median follow-up of 49 months, there was no difference in local control between tumors with or without cartilage invasion.

Conclusions: For these tumors involving the AC, VF mobility was the only significant factor related to thyroid cartilage invasion and should be taken into consideration when planning surgery.