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Keywords:

  • glottic carcinoma;
  • recurrence;
  • irradiation failure;
  • tumor spread;
  • voice-preserving surgery

Abstract

Background

The assessment of the precise tumor extent of recurrent glottic carcinomas is a challenge.

Methods

The histologic characteristics of 29 recurrent glottic carcinomas after radiation failures, initially classified as T1 and T2, were analyzed on whole-organ slices. The growth patterns of 21 recurrent prT3 and prT4 and 52 primary pT3 and pT4 carcinomas were compared.

Results

Fifteen of 29 (52%) recurrent carcinomas were understaged by imaging studies and endoscopy. Most recurrent carcinomas presented with multicentric tumor foci, whereas most primary carcinomas with a concentric tumor growth pattern (p < .05). Undifferentiated dissociated tumor cells were observed more often in the vicinity of recurrent tumor foci than of the primary tumor mass (p < .05).

Conclusion

Recurrent glottic carcinomas are often understaged and present with multiple tumor foci dispersed in different regions of the larynx. If voice-preserving salvage surgery is considered as a treatment option, these facts should be kept in mind. © 2006 Wiley Periodicals, Inc. Head Neck 2007