Vocal fold mobility as the main prognostic factor of treatment outcomes and survival in stage II squamous cell carcinomas of the glottic larynx

Objective: This study aimed to assess the influence of supra-and subglottic extensions and vocal fold mobility on outcome in a large monocentric cohort of 148 patients treated for tumour-node-metastasis stage T₂N₀ glottic carcinomas. Methods: In all, 107 glottic carcinoma patients had normal vocal fold mobility (T_2aN₀), and 41 had impaired vocal fold mobility (T_2bN₀). Treatment decisions were made by a multidisciplinary team. Results: Vocal fold mobility was associated with overall survival, disease-free survival, local control, larynx preservation and laryngectomy-free survival. For patients with T_2a lesions, local control, laryngectomy-free survival and disease-free survival improved after surgery but overall survival did not. For patients with T_2b lesions, local control, laryngectomy-free survival, disease-free survival and overall survival were all higher after surgery than after radiotherapy. Conclusion: This study highlights for the first time the importance of vocal fold mobility in treatment outcomes and is the first to assess its influence on survival. Updated tumour-node-metastasis classifications should consider the distinction between T_2a and T_2b lesions.