How much subglottic extension from a primary glottic tumor would make you treat the regional lymph nodes?
Degree of subglottic extension is often difficult to determine from office scope examinations and ENTs do not always include this. Do you have any tips or rule of thumb?
When covering nodes in case with subglottic extension, do you always include level VI?
2 Answers
Mednet Member
Radiation Oncology · Banner MD Anderson Cancer Center
Answered on
This is a question that may be more complicated than it looks, though I recognize that Dr. @Dr. First Last has a wealth of experience in this area.
The first issue is that the definition of the cranial extent of the subglottic region is not standardized. It can vary from just under the cord to 5 mm below the cord to 1 cm below the cord, depending on the author. Our group uses 5 mm below the cord, which may be the most common choice.
With a tumor starting on the true cord and extending inferiorly, then, there are 3 scenarios:
- The tumor extends less than 5 mm below the cord with normal vocal cord mobility. We would not characterize this as a significant subglottic extension (still T1) and would treat with small fields to 63 Gy/28 fxs. We wou...
Join for free or sign in to see the full answer
Mednet MemberInvited Expert
Radiation Oncology · University of Florida
Answered on
The top of the trachea.
Join for free or sign in to see the full answer