Histologic characteristics and tumor spread of recurrent glottic carcinoma: Analysis on whole-organ sections and comparison with tumor spread of primary glottic carcinomas

Background The assessment of the precise tumor extent of recurrent glottic carcinomas is a challenge. Methods The histologic characteristics of 29 recurrent glottic carcinomas after radiation failures, initially classified as T1 and T2, were analyzed on whole‐organ slices. The growth patterns of 21 recurrent prT3 and prT4 and 52 primary pT3 and pT4 carcinomas were compared. Results Fifteen of 29 (52%) recurrent carcinomas were understaged by imaging studies and endoscopy. Most recurrent carcinomas presented with multicentric tumor foci, whereas most primary carcinomas with a concentric tumor growth pattern (p < .05). Undifferentiated dissociated tumor cells were observed more often in the vicinity of recurrent tumor foci than of the primary tumor mass (p < .05). Conclusion Recurrent glottic carcinomas are often understaged and present with multiple tumor foci dispersed in different regions of the larynx. If voice‐preserving salvage surgery is considered as a treatment option, these facts should be kept in mind. © 2006 Wiley Periodicals, Inc. Head Neck 2007