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T1 glottic carcinoma involving the posterior commissure

Authors

  • Jacob Shvero MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    2. Rabin Medical Center, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    • Department of Otorhinolaryngology–Head & Neck Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqwa, Israel 49100

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  • Itzhak Shvili MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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  • Aviram Mizrachi MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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  • Thomas Shpitzer MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    2. Rabin Medical Center, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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  • Benny Nageris MD,

    1. Department of Otolaryngology–Head and Neck Surgery, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    2. Rabin Medical Center, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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  • Rumelia Koren MD,

    1. Department of Pathology, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    2. Rabin Medical Center, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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  • Tuvia Hadar MD

    1. Department of Otolaryngology–Head and Neck Surgery, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
    2. Rabin Medical Center, Petah Tiqwa, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Abstract

Objectives/Hypothesis:

The posterior commissure is an uncommon site of glottic carcinoma. The aim of the study was to compare the clinical and prognostic characteristics of glottic carcinoma of the posterior commissure and the vocal cords.

Study Design:

Retrospective case control study.

Methods:

The study group consisted of 40 patients aged 32 to 84 years (mean, 62.7 ± 10.7) diagnosed with T1 glottic carcinoma involving the posterior commissure from 1960 to 2008. Data on clinical features and outcome were collected from the medical files and compared with the data for 42 patients aged 30 to 87 years (mean, 64.4 ± 11.8) with T1 vocal cord carcinoma.

Results:

There were no significant differences in clinical characteristics between the groups except for the higher rate of smokers among the patients with vocal cord carcinoma (95% vs. 65%, P = .01). All patients were treated primarily with radiotherapy. Disease-free survival in the posterior commissure carcinoma group was 76.1% after 5 years and 72.3% after 10 years, and in the vocal cord carcinoma group, 95% after 5 and 10 years (P = .012). The risk of recurrence was higher when the tumor involved the posterior commissure (hazard ratio, 8.78; 95% CI, 1.12–68.5, P = .038).

Conclusions:

T1 glottic carcinoma involving the posterior commissure has a more aggressive biological behavior and a worse prognosis than T1 glottic carcinoma of the vocal cords. Smoking, which is an important pathogenetic factor in vocal cord carcinoma, plays a lesser role in posterior commissure carcinoma. Laryngoscope, 2009

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