Participants
The study group consisted of adult patients with pathologically proven
T1/N0/M0 glottis squamous carcinoma who were treated and followed at the
Ear-Nose-Throat (ENT) Department of one hospital from October 2008 to
October 2014.All the surgeries were performed by 3 specialists, each
with more than 10 years of surgical experience. Patients were excluded
if they had a second primary tumor, were younger than 18 years old,
received primary radiotherapy, had a repeated cancer, or if data were
missing or insufficient for analysis.
Tumors were staged according to the American Joint Committee on Cancer
(AJCC) TNM cancer staging system (sixth edition, 2002) [10].
Involvement of the anterior commissure was defined as visible spread of
the tumor to the anterior-most extent of a single membranous vocal fold
or continuously from one vocal fold to the other. For each patient, the
surgeons explained the detailed benefits and disadvantages of each kind
of therapy, including the effect on voice quality. In our institution,
RFA is always the primary surgical option. But, we choose open surgery
if the patient’s larynx cannot be sufficiently exposed, if there is deep
infiltration of the tumor into the anterior commissure, or if there is a
large stage T1b tumor involving the anterior commissure. The surgeon’s
determinations of deep infiltration and tumor stage were based on
evaluation of preoperative electronic laryngoscopy and computed
tomography (CT) images.