A 60-year-old male with squamous cell carcinoma of the glottic larynx is found on CT to have erosion through the thyroid cartilage. According to AJCC 8th edition, how does thyroid cartilage invasion affect the T-staging of laryngeal cancer?

• A It upstages the tumor to T3 regardless of cord mobility
• B It upstages the tumor to T4a because it represents extralaryngeal spread ✓
• C It does not affect T-staging unless there is cord fixation
• D It upstages the tumor to T4b indicating unresectability

Explanation

In AJCC 8th edition laryngeal staging, invasion through the thyroid cartilage or extension to tissues beyond the larynx (extralaryngeal spread) classifies the tumor as T4a. T4a is resectable. T4b involves the prevertebral space, encases the carotid artery, or involves mediastinal structures and is considered unresectable. Cartilage erosion alone without extralaryngeal extension would be T3.

Reference: AJCC Cancer Staging Manual, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.