الفهرس 
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Abstract
The diagnosis and primary treatment of laryngeal squamous cell carcinoma that involves the anterior commissure (AC) tend to be controversial and prone to failure due to problems in staging and delineation of the AC as a separate anatomic entity. This thesis compares between the surgical and the radiotherapy treatment strategies of such cases as regards their 5 year survival, 5 year disease free survival and 5 year local control rates.
A review of the literature published during the last twenty years, available through the Medline Database, produced 163 studies with data and references concerning the AC. Of these, only 12 studies had relevant data; 2 were case control and 10 were case series. With the two case control studies, there were 281 cases treated with surgery, of which 38 recurred after 5 years. With Radiotherapy, there was 81 cases of which 23 recurred. Using odd’s ratio, the data illustrated that the 5 year local control was better with surgery than with radiotherapy.
Using relevant data from the ten case series studies concerning combined T1-T2 5 year disease free survival, a comparison was done between the number of total patients and the number of patients who survived. from the data collected, there was a total of 97 cases treated with radiotherapy, of which 63 were free of the disease 5 years after treatment (65.9%), compared with 218 cases treated with surgery, of which 165 were controlled after 5 years (75.5%).
The data was then subdivided into separate T groups. For T1 radiotherapy, there were 52 patients with 35 in remission (76.3%). For T2 radiotherapy, there were 45 patients of which 28 were in remission (62%). For T1 surgery, there were 164 patients of which 129 were in remission (78.7%). For T2 surgery, there were 54 patients of which 36 were in remission (66.7%).
Using data from the case series papers concerning combined T1-T2 5 year overall survival, a comparison was done between the number of total patients and the number of cases still alive. For radiotherapy, there were 151 patients of which 113 survived 5 years post treatment (74.8%) compared with 207 surgical patients of which 172 (83.1%) survived.
This data was then subdivided according to T specific class, for T1 radiotherapy, there were 75 patients of which 62 survived (82.7%). With T2 radiotherapy, there were 16 patients of which 9 survived (56%). With T1 surgery; there were 81 patients of which 67 survived (82.7%), and with T2 surgery, there were 46 patients of which 37 survived (80%).
To summarise , surgery was proven to be, statistically, the better alternative available except in cases of T1 where the results were similar.