IMPLICATIONS OF CARTILAGE INVASION IN SURGICALLY TREATED LARYNGEAL CARCINOMA

Background. Cartilage invasion adversely affects the outcome of laryng eal carcinoma treated with radiotherapy. The UICC and American Joint C ommittee on Cancer (AJCC) classify laryngeal carcinoma with cartilage invasion as T4 or stage IV. Methods. This study examines the prognosti c significance of cartilage involvement in T3,4 NO,1 glottic carcinoma treated with total laryngectomy. Patients with tumor extension to pha rynx, tongue, and thyroid gland, extracapsular spread, positive resect ion margins, and less than 2 years' follow-up were excluded.Results. S ixty-seven pT3 (cartilage free of tumor) and 37 pT4 (cartilage invaded by tumor) cases were studied. The difference between the pT3 and pT4 groups in terms of local or regional recurrence, distant metastasis, a nd determinate survival was not significant. Conclusions. The results of this study question the use of cartilage invasion as a staging para meter for surgically treated laryngeal carcinoma. However, further stu dies with larger sample sizes are required to fully elucidate the prog nostic significance, ii any, of cartilage invasion in surgically treat ed cancer of the larynx. (C) 1998 John Wiley & Sons, Inc.