Ten-year Survivors After Contemporary Management of Advanced 'Horseshoe' Anterior Commissure Laryngeal Cancer.

Background: Combinations of treatment modalities for locally extensive carcinomas of the larynx constitute the standard of care. Advanced 'horseshoe' anterior commissure laryngeal cancer (HACLC) is a disease entity that has not received much attention in the literature. The aims of this study were to evaluate prolonged survival in patients after standard combined therapy for HACLC and to identify clinicopathological factors influential towards an extended outcome.

Patients And Methods: Fourteen patients (10-year survivors) with stage III or IV laryngeal cancer involving the anterior commissure and both true vocal cords were treated with total laryngectomy (and postoperative radiotherapy in 11 individuals).

Results: During follow-up, ranging from 123 to 256 months, locoregional recurrent disease and distant metastasis were not observed. Complications after therapy were manageable and few. The long-term survivors were particularly difficult to characterize.

Conclusion: The optimal treatment for advanced HACLC has not been clarified; however, in this study, total laryngectomy and the indicated use of postoperative radiotherapy, were successful in achieving long-term disease-free survival. Predictive factors for longevity were not detected in this limited experience.