Stages 1 and 2 epidermoid carcinoma of the glottic larynx: involvement of the anterior commissure.

Data on 55 patients with stages 1 and 2 epidermoid carcinoma of the glottic larynx treated from 1978 to 1988 were retrospectively reviewed. Twenty-six patients had involvement of the anterior commissure (AC). Local and ultimate local control rates achieved, respectively, with mean follow-up of 41 months (range, 6-120 months), were as follows: 92% and 100% for patients without AC involvement and stage T1a lesions, 60% and 80% for patients without AC involvement and stage T2 lesions, 100% and 100% for patients with AC involvement and stage T1a lesions, 100% and 100% for patients with AC involvement and stage T1b lesions, and 75% and 100% for patients with AC involvement and stage T2 lesions. There was no correlation between the degree of response at completion of treatment and local control. There was no difference in the local control rate of patients with and without involvement of the AC. Factors associated with a decreased local control rate include extensive subglottic extension and use of a single lateral field technique. Surgical salvage after failure of radiation therapy is effective and can be performed with acceptable morbidity.