Outcomes of frontolateral vertical partial laryngectomy in T1b glottic carcinomas

Abstract

Background: The treatment of T1b glottic carcinomas with invasion of the anterior commissure (AC) is still a challenge in larynx oncology. The diversity in treatment protocols is due to the difficulty in achieving safety margins of resection, especially in the AC.

Objective: The treatment success rate of frontolateral vertical partial laryngectomy (FVPL) for the treatment of stage T1b squamous cell carcinoma of the glottic larynx infiltrating the AC.

Material and methods: Clinical data of patients, who were diagnosed with stage T1b squamous cell carcinoma of the glottic larynx and who underwent a FVPL from 01/2003 to 12/2016 in our ENT clinic were retrospectively evaluated. Clinical and oncological outcomes were analyzed.

Results: 39 patients were included in this study. The mean follow-up duration was 79.95 ± 20.59 months. Intraoperative R0 resection was achieved in all patients. In 33.3% patients, documented complications were tissue granulation and synechia formation in the glottic area. The 5-year recurrence-free survival was 82.1%, the 5-year overall survival rate 97.4%, and the 5-year laryngeal preservation rate 94.8%.

Conclusion: Our clinical data demonstrate that T1b glottic carcinomas with invasion of the AC can be effectively treated with FVPL. The outcome is similar to other methods such as transoral laser microsurgery, supracricoidal partial laryngectomy, and radiotherapy.

Keywords: Squamous cell carcinoma; T1b; anterior commissure AC; frontolateral vertical partial laryngectomy FVPL; glottic larynx.