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Transoral laser resection of glottic carcinoma: what is the significance of anterior commissure involvement?

  • K A Stephenson (a1) and J J Fagan (a2)



The optimal management of glottic carcinoma involving the anterior commissure is controversial.


A retrospective analysis was conducted of 76 patients with glottic squamous cell carcinoma treated by transoral carbon dioxide laser resection by a single surgeon.


Sixty-three patients (with tumour stage Tis–T3) were eligible for inclusion. Thirty patients had involvement of the anterior commissure; these patients were significantly more likely to have either uncertain or positive margins (63.3 vs 30.3 per cent, p = 0.012), and were also more likely to receive adjuvant radiotherapy (40 vs 3.2 per cent, p = 0.0005). The overall laryngeal preservation rate was 96.8 per cent; there was no statistically significant difference between those with and without anterior commissure involvement (96.7 and 96.9 per cent respectively).


Transoral laser resection with the use of adjuvant radiotherapy in a minority of patients with adverse pathological findings can be recommended for the primary treatment of anterior commissure glottic cancer from an oncological perspective; excellent local control and laryngeal preservation rates can be achieved.


Corresponding author

Address for correspondence: Prof J J Fagan, Division of Otolaryngology, University of Cape Town, Cape Town, South Africa E-mail:


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Presented at the 50th Congress of the South African Society of Otorhinolaryngology, Head and Neck Surgery, 18–21 October 2014, Cape Town, South Africa.



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Transoral laser resection of glottic carcinoma: what is the significance of anterior commissure involvement?

  • K A Stephenson (a1) and J J Fagan (a2)


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