Background. The objective of this study is to assess the accuracy of pre- and posttherapeutic staging of endolaryngeal cancer involving anterior commissure. Materials and Methods. 127 patients were included in this retrospective study, and laryngectomy (partial or radical) was achieved in all of them. Initial radioclinical evaluation (cT) was performed (endoscopy-CT scan) and compared with postoperative histopathological findings. Results. 24,6% of cT2 and 33,3% of cT3 laryngeal tumors were reclassified pT4 after the histopathological examination. Conclusion. pre-therapeutic staging (combining endoscopy-CT scan) of endolaryngeal cancer involving anterior commissure is inadequate and sometimes underestimates thyroid cartilaginous invasion. Nethertheless, a precise diagnostic assessment by surgery with postoperative histological findings is possible. Cartilage and/or paraglottic structures are involved, or not, on the laryngectomy specimen exam. So surgery should always be discussed in first line in transdisciplinary meeting for endolaryngeal cancer management. 1. Introduction Laryngeal cancers represent about 30% of head and neck cancers with a high incidence for the glottic location (from 25 to 85%) [1, 2]. There is currently no recommendation from the UICC (International Union Against Cancer) for pre-therapeutic assessment (endoscopy, computed tomography, and magnetic resonance imaging) specifying in particular the need to involve them. Now the evaluation of the cartilaginous extension, especially thyroid, is an important element in the pre-therapeutic assessment of the endolaryngeal cancer. In case of infiltration the tumor is classified cT4a, and the patient is amenable to an aggressive therapy given the high risk of local recurrence and low radiosensitivity. The same applies to the infiltration of paraglottic areas. The purpose of this study is to evaluate, by comparing, the existing correlation between preoperative radiological classification of endolaryngeal tumors involving the anterior commissure (endoscopy, CT scan) and postoperative classification (pT pathology). 2. Materials and Methods 2.1. Patients This is a single-center retrospective study (1998–2005) conducted at the Croix-Rousse hospital on 127 patients with endolarynx cancer involving the anterior commissure. Men are in majority (122 cases). All these patients were surgically treated and 32 of them with a total laryngectomy, the 95 other patients with a partial laryngectomy. Squamous-cell carcinoma represented the main pathology (124 patients) with a case of adenosquamous carcinoma, a
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