Glottic microinvasive carcinoma: is it different from carcinoma in situ?

OBJECTIVE

To determine the impact of different treatment modalities on the outcome of microinvasive carcinoma.

DESIGN

Retrospective review of patients presenting between 1976 and 1990.

SETTING

Fifteen patients with microinvasive carcinoma (MIC) of the glottic larynx treated at McGill University teaching hospitals.

METHODS

All patients had MIC involving the glottis confirmed pathologically. Nine patients (60%) had right vocal cord involvement, four (27%) had left vocal cord involvement, and two (13%) had involvement of both cords. Five patients (33%) were treated by stripping(S), three patients (20%) by stripping and radiotherapy (S + RT), and six patients (40%) by radiotherapy (RT) alone as the primary treatment. Only one patient underwent hemilaryngectomy.

RESULTS

With a median follow-up time of 63 months (range 20-208 months), the 15-year actuarial survival rate is 100% for all patients.

CONCLUSIONS

Surgery alone, RT alone, or S + RT is equally effective in treating MIC of the glottic larynx; however, single-modality therapy is preferred. The choice of treatment modality should be individualized for each patient.