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PubMed2000

[Operations for laryngeal carcinoma with reservation of laryngeal function].

OBJECTIVE: To study the long term results and functional recovery of partial laryngectomy in the treatment of glottic and supraglottic types of laryngeal carcinoma. METHOD: A series of 70 cases operated on between July 1978 and August 1998 were analysed, of whom 60 were glottic, 10 were supraglottic type laryngeal carcinoma. Among them, 22 cases underwent vocal cord resection, 22 vertical hemilaryngectomy, 17 Majer-Piquet's operation, 7 horizontal hemilaryngectomy, 2 Arslan's operation. RESULT: 1, 3, 5-year survival rates were 98.53%, 87.04% and 78.26% respectively. Decannulation rate was 100%. All patients could finally take food by mouth without inspiration, and could speak as soon as decannulated. Complication and recurrence rates were 15.71% and 13.04% separately. CONCLUSION: Partial laryngectomy is an effective operation on laryngeal carcinoma with reservation of laryngeal function. It not only can totally excise neoplasm and prolong life, but also can better reserve laryngeal function and improve the quality of patient's life.

Adult↗

PubMed1976

[Results of treatment for laryngeal carcinoma in Würzburg].

From 1960 through 1972, altogether 418 patients with laryngeal carcinoma have been treated at Würzburg, 333 = 82% of these by primary radiation therapy with Co-60 gamma-rays. The results are reported and analyzed in dependence on prognostic factors as tumor site and extension, formation of metastases and age of the patient. Five-year survival of primarily irradiated cases from 1960 to 1967; Glottic T1 = 90%, T2 = 70%, T3 -31%. Supraglottic T2 = 51%, T3 =20%, T4 = 16%. Quota of cases with posterior surgical treatment: Glottic = 8% supraglottic = 28%. The attempt to preserve the larnyx function by means of radiation therapy as an initial measure does not bring along any risk for the patient. The incidence of recurrences with secondary surgical treatment is not smaller than with irradiation only.

Adult↗

PubMed2002

[Reconstruction with pyriform sinus mucosa in partial laryngectomy].

OBJECTIVE: To assess the effectiveness of reconstruction with pyriform sinus mucosa in partial laryngectomy and resumed laryngeal function. METHOD: A total of 198 cases of laryngeal cancer who had undergone partial laryngectomy from 1980 to 1995 in our hospital were retrospectively reviewed. Defect of larynx were repaired with pyriform sinus mucosa in all cases. Surgery of local lesions: 87 cases underwent supraglottic horizontal partial laryngectomy, 65 vertical or extended vertical partial laryngectomy, 46 horizontal vertical partial laryngectomy. RESULT: In cases underwent supraglottic horizontal partial laryngectomy, postoperative decannulation rate is 100%, 5 year survival rate is 84.70% and functions of voice, respiration and deglutition were all preserved well. In cases underwent vertical or extended vertical partial laryngectomy, decannulation rate is 87.67% and 5 year survival rate is 86.15%. Functions of respiration and deglutition are good but existent hoarseness. In the earlier stage after operation, there was serious aspiration in the cases underwent horizontal vertical laryngectomy and it took patients more time to overcome aspiration by practice. In this group, decannulation rate is 82.60% and 5 year survival rate is 78.26%. all cases present hoarseness and part of them can't be extubated because of glottic stenosis. CONCLUSION: The authors believe that this method of surgery is safe and beneficial to some patients with partial laryngectomy. Laryngeal functions can be well preserved with this technique.

Adult↗

PubMed2003

[Detailed mapping and clinical significance of loss of heterozygosity on 9p13-23 in laryngeal squamous cell carcinoma by microsatellite analysis].

BACKGROUND & OBJECTIVE: Microsatellites are the repeated DNA sequences scattered widely within the biological genomes and closely linked with many important genes. In carcinogenesis, microsatellites often display loss of heterozygosity(LOH) as tumor suppressor genes. Some microsatellite loci often exist in the hot spots of LOH at high frequency in some specific maligances. The tumor suppressor genes, which are associated with the development and progression of the tumor, possibly harbor in the vicinity of these hot spots. Therefore, the study of LOH by microsatellite analysis is an important way to detect the putative tumor suppressor genes. This study was designed to refine the hot spots of LOH on 9p13-23 in laryngeal squamous cell carcinoma and compare the correlation between the incidence of microsatellite LOH and the clinicopathological parameters. METHODS: Tumor tissues were obtained from paraffin embedded sections with microdissection. Genomic DNA was extracted from tumor tissues and peripheral blood lymphocytes with the phenol-chloroform. Polymerase chain reaction(PCR) amplification and denaturing gel electrophoresis were performed on a set of 42 laryngeal squamous cell carcinoma and corresponding peripheral blood lymphocytes using 13 highly polymorphic microsatellite markers on 9p13-23. The correlation was analyzed between microsatellite LOH at the high frequency on 9p13-23 and clinicopathological characteristics in the patients with squamous cell carcinoma of larynx. RESULTS: (1)Of the 42 laryngeal cancers, 41(97.6%) showed LOH in at least one of the microsatellite markers tested on 9p13-23. The most frequently deleted marker was D9S162 in 17 of the 19 (89.5%) informative samples. The marker D9S171, which is located on 9p21, had LOH detected in 12 of the 15 informative cases (80.0%). LOH at the D9S1748 marker (closest to the p16 gene locus) was detected in 18 of the 36 informative cases (50.0%). (2)Allelic deletion mapping revealed two minimal regions of LOH encompassing markers D9S161-D9S171 on 9p21 and IFNA-D9S162 on 9p22-23. (3) Multiple LOH (>or= 4) on 9p21-23 was found more frequently in the patients under 60 years, with supraglottic squamous cell carcinoma or cervical lymph node metastasis than those over 60 years, with glottic squamous cell carcinoma or without cervical lymph node metastasis (P< 0.01,P< 0.01,P< 0.05, respectively). On the contrary, there was no correlation between T stages or pathologic classification and the frequency of LOH on 9p21-23 in 42 squamous cell carcinoma of larynx. CONCLUSION: These findings imply the presence of at least two putative tumor suppressor genes on 9p13-23 in laryngeal squamous cell carcinoma. Multiple genetic alterations are probably implicated in supraglottic squamous cell carcinoma with cervical lymph node metastasis in younger patients.

Adult↗

PubMed1999

[The reconstruction of laryngeal function in subtotal laryngectomy with preservation of arytenoid cartilage].

OBJECTIVE: To evaluate subtotal laryngectomy with preservation of arytenoid cartilage to reconstruct laryngeal function in T3 glottic or supraglottic laryngeal cancer. METHODS: Subtotal laryngectomy with preservation of arytenoid cartilage to reconstruct laryngeal function was reviewed in 20 patients with T3 laryngeal cancer(3 cases with glottic cancer and 17 cases with supraglottic cancer). Recurrent laryngeal nerve was preserved during surgery. The mucous membranes between cricoid cartilage and pharynx were sewed up accordingly. RESULTS: All patients had restored phonation and swallowing functions. The 3- and 5-year survival rates were 94.1% and 91.8% respectively. Decannulation rate was 95.0%. CONCLUSION: Subtotal laryngectomy with preservation of arytenoid cartilage is recommended for T3 laryngeal cancer.

Aged↗

PubMed2000

[Long-term follow-up result of partial laryngectomy].

OBJECTIVE: To study the long-term follow-up result of partial laryngectomy and reservation of laryngeal function. METHODS: Three hundred and seventy-nine patients who underwent partial laryngectomy from 1986 to 1995 were summarized (male 290 cases, female 89 cases). Among them, 184 cases were supraglottic carcinomas (T1 8 cases, T2 115, T3 48, T4 13, according to UICC in 1992), 192 cases were glottic carcinomas (T1 115, T2 63, T3 13, T4 1), 3 cases were transglottic carcinomas (T2 1, T3 2). In common 8 kinds of operations were performed: 26 cases underwent cordectomy, 138 vertical laryngectomy, 7 frontolateral laryngectomy, 12 horizontal glottic laryngectomy (middle part of the larynx), 58 supraglottic laryngectomy, 95 horizontovertical (3/4) laryngectomy, 24 subtotal laryngectomy with cricoglossoepiglottic anastomosis, 19 near-total laryngectomy with cricoglossal anastomosis (with reservation of unilateral arytenoid cartilage). 193 cases underwent concurrent neck dissection(121 unilateral, 72 bilateral). RESULTS: All cases restored their phonation and overcame aspiration with removing nasal feeding from 7 to 23 days after operations. 362 cases were decannulated from 9 days to 3 months after operations. Another 8 cases were decannulated after a secondary plastic operation. Decannulation rate was 97.6%. The three, five and ten year survival rates were 86.8% (329/379), 81.3% (266/327) and 69.4% (120/173) respectively. CONCLUSION: Partial laryngectomy is a kind of radical operation with reservation of laryngeal function. Mastering indications strictly, correct operation choices, excellent surgical skills and perfect repairing technique are bases of improving life qualities and curative effect.

Adult↗

PubMed2000

[Supracricoid partial laryngectomy in laryngeal cancer].

OBJECTIVE: To assess the effectiveness of supracricoid partial laryngectomy in the treatment of laryngeal cancer and the reconstructed laryngeal functions. METHODS: This study involved 29 patients operated on from 1978 to 1998 using this surgical procedure. In these cases, 18 were male and 11 were female with a mean age of 55.4 years (range, 38 to 70 years). The disease was classified according to the 1987 UICC system. There were 10 supraglottic cancers (3 T2N0, 1 T2N1, 3 T3N0, 2 T3N1, 1 T3N2), and 19 glottic cancers (12T2N0, 1T2N1, 4T3N0, 2T3N1). Two subtypes of supracricoid partial laryngectomy were performed, one with epiglottis preserved and reconstructed with cricohyoidepiglottopexy (CHEP), the other involved epiglottic resection and reconstructed with cricohyoidopexy (CHP). RESULTS: The voice was good in all cases. Twenty-seven cases were decannulated (93.1%). All cases had overcome the aspiration by practice. The overall 3-year and 5-year survival rates were 89.7% and 75.9%. CONCLUSION: Supracricoid partial laryngectomy was appropriate for selected supraglottic and glottic cancers.

Adult↗

PubMed2003

[Comparison of laryngoscopy and CT-scan results before partial laryngectomy].

OBJECTIVES: Careful assessment of tumor extension is required before partial laryngectomy in order to ensure optimal carcinological safety. Laryngoscopy and CT-scan constitute the explorations of reference. We investigated the value of these two examinations and their association for the evaluation of glottic and supraglottic tumors. METHOD: We compared laryngoscopy and CT findings with those of the pathologic examination of the surgical specimen in a retrospective study of 57 patients. RESULTS: The results were presented by T-staging, then as a function of the laryngeal floor of the tumor and the anatomic localization. The laryngoscopy findings were most contributive for small tumors. Large spaces are better examined with the scanner. CONCLUSION: This study showed that the performance of laryngoscopy and CT-scan for the assessment of glottic and supraglottic tumors can be improved by a better knowledge of the limitations of each type of explorations for this type of assessment. CT-scan currently provides a better topographic assessment of the tumor than endoscopy; even higher performance can be expected with the advent of technological advances.

Adult↗

PubMed2004

Detailed deletion mapping of loss of heterozygosity on 9p13-23 in laryngeal squamous cell carcinoma by microsatellite analysis.

BACKGROUND: This study was designed to investigate the hot spots of microsatellite loss of heterozygosity (LOH) on 9p13-23 in laryngeal squamous cell carcinoma and to find out the correlation between the incidence of microsatellite LOH and the clinicopathological parameters. METHODS: Tumor tissues were obtained from paraffin embedded sections with microdissection. Genomic DNA was extracted from tumor tissues and peripheral blood lymphocytes with the phenol-chloroform. Polymerase chain reaction (PCR) amplification and denaturing gel electrophoresis were carried out in a set of 42 squamous cell carcinoma (SCC) of larynx and corresponding peripheral blood lymphocytes using 13 highly polymorphic microsatellite markers on 9p13-23. The correlation was analyzed between microsatellite LOH at the high frequency on 9p13-23 and clinicopathological parameters in the patients with squamous cell carcinoma of larynx. RESULTS: Of the 42 laryngeal cancers, 41 (97.6%) showed LOH in at least one of the microsatellite markers tested on 9p13-23. The most frequently deleted marker was D9S162 in 17 of the 19 (89.5%) informative samples. The marker D9S171, which is located on 9p21, had LOH detected in 12 of the 15 informative cases (80.0%). LOH at the D9S1748 marker (closest to the p16 gene locus) was detected in 18 of the 36 informative cases (50.0%). Allelic deletion mapping revealed two minimal regions of LOH encompassing markers D9S161-D9S171 on 9p21 and IFNA-D9S162 on 9p22-23. Multiple LOH (> or = 4) on 9p21-23 was found more frequently in the patients under 60 years, with supraglottic SCC or cervical lymph node metastasis than those over 60 years, with glottic SCC or without cervical lymph node metastasis (P < 0.01 or 0.01, 0.05, respectively). On the contrary, there was no correlation between T stages or pathologic classification and the frequency of LOH on 9p21-23 in 42 SCC of Larynx. CONCLUSIONS: These findings imply the presence of at least two putative tumor suppressor genes on 9p13-23 in laryngeal SCC. Multiple genetic alterations are probably implicated in supraglottic SCC with cervical lymph node metastasis in younger patients.

Adult↗

PubMed2004

[Largest extension of CO2 laser surgery for laryngeal cancer in experimental animals].

OBJECTIVE: To explore the security and limit resection extension of CO2 laser surgery for laryngeal cancer in experimental animal under self-retaining laryngoscope. METHODS: Ten experimental dogs were selected and received CO2 laser surgery with self-retaining laryngoscope. Vertical partial or supraglottic horizontal laryngectomy was performed according to the surgical criteria. All the dogs were killed immediately (5/10) or 40 days later(5/10) by using air embolus postoperatively. The whole larynx was taken out, and specimens were embedded with colloidion and then serially sectioned. Dimension of excision and wound surface recovery status were observed. RESULTS: All the operations on experiment animals were successful and the results were satisfactory. The excision dimension was the same as standard surgery. Gross specimens and serial sectioning staining of 5 dogs were performed. And the other 5 dogs wound surface had already recovered. CONCLUSIONS: CO2 laser surgery was comparable with traditional vertical partial laryngectomy and supraglottic horizontal laryngectomy for excision size. Animals were able to survive the surgery, wound surface could recover spontaneously. It suggested the possibility of extended laryngectomy with laser.

Animals↗

PubMed2004

Interaction effects and population-attributable risks for smoking and alcohol on laryngeal cancer and its subsites. A case-control study from Germany.

OBJECTIVES: To assess the joint effect of smoking and alcohol consumption on laryngeal risk on tumor subsites. METHODS: Population-based case-control study in South-West Germany with 257 histologically confirmed cases (236 males, 21 females), age 37 to 80 years, and 769 population controls (702 males, 67 females), 1:3 frequency matched by age and sex. RESULTS: Half of the tumors (50.6%) were glottic or subglottic, 17.5% were supraglottic. Due to advanced stage, the subsite of 31.9% of the tumors could not be determined clearly. There is a strong increase in risk with increasing tobacco consumption with an odds ratio (OR) of 59.8 (95% confidence interval (CI) 21.3-167.3) for heavy smoking (>80 packyears (py)), all cases combined. In comparison to current smokers, cancer risk is reduced for ex-smoking (>2 years) OR=0.36, 95% CI 0.24-0.53. The risks were higher for supraglottic than for glottic and subglottic tumors. The effect of alcohol is not as strong. A significantly increased odds ratio of 2.0, 95% CI (1.0-3.9) results for 75-100 g ethanol/day only for glottic and subglottic tumors. The OR rises from 2.2, 95% CI (1.1-4.3) for 100-150 g ethanol/day to 4.3, 95% CI (1.4-13.2) for more than 150 g ethanol/day (all models adjusted for education). The joint effect of smoking and alcohol results appears sub-multiplicative but super-additive. Almost 90% of the tumors can be attributed to both factors. CONCLUSION: Contrary to earlier investigations we observed a sub-multiplicative effect of smoking and alcohol. The risk for persons with both high alcohol and tobacco consumption is extremely high which indicates the importance of intervention.

Aged↗

PubMed2005

[Oncological failure after partial laryngectomy for laryngeal carcinoma].

The aim of the study was an evaluation of oncological failures after partial laryngectomies for treatment of laryngeal carcinoma. A retrospective analysis was done on 325 partial laryngectomies performed during 18 years (1980-1997) at Otolaryngology Department Medical University of Lódź. Seventy four failures (22.8%) were observed, among them local recurrences--in 43 patients (13.2%), nodal recurrences--in 9 patients (2.8%), distant metastases--in 6 patients (1.8%), second primary malignant neoplasms--in 11 patients (3.4%) and spread of neoplastic disease--in 8 patients (2.5%). Local recurrence was statistically the most often type of failure--58.1% in comparison with frequency of the others (p<0.001). The failures, according to type of partial laryngectomy, occurred rarely after cordectomy--17.5%, the most frequently were noted after supraglottic horizontal laryngectomy--42.3% (p<0.01) and fronto-lateral/fronto-anterior laryngectomy--30.9% (p<0.05). Majority of failures were diagnosed within first 2 years after primary treatment--55.4% of all failures in comparison with third (12.2%), fourth and fifth years (5.4%), but they were also often observed over 5 years (27%) (p<0.05). A statistical difference in percentage of failures in the periods until 5 years and over 5 years was noted only for cordectomy (23.8% and 4.9% respectively, p<0.001) and supraglottic laryngectomy (56.3% and 12.5% respectively, p<0.05). Systematic control of patients after partial laryngectomies is necessary all over their life.

Adult↗

PubMed2005

Factors influencing tumour relapse after total laryngectomy.

OBJECTIVES: To determine the prognostic factors predictive of tumour recurrence after surgical treatment for laryngeal carcinoma with total laryngectomy. STUDY DESIGN/METHODS: Retrospective review of 308 patients with laryngeal carcinoma who underwent total laryngectomy in the ENT Department of AHEPA University Hospital between 01/01/1992 and 31/12/1999. In 238 patients, total laryngectomy was performed as primary treatment of laryngeal carcinoma, and in 70 others as treatment of tumour recurrence following radiotherapy or partial surgery. Follow-up was standardized, following a strict protocol, the mean follow-up time was 68 months. RESULTS: During post-operative follow-up, recurrences were observed in 96 of 308 patients (31%). The relapse rates were 27% (65 of 238) for patients treated with primary total laryngectomy, and 44% (31 of 70) for those treated for recurrence following previous treatment. The difference in relapse rates was statistically significant. In 39 of 238 (16%) cases treated with primary total laryngectomy cervical lymph node infiltration was present at diagnosis and radical or modified neck dissection was performed. The tumour recurrence rate in this group was 46% (18 of 39), while in metastatic node-free patients the relapse rate was 24% (47 of 199) [p < 0.05]. Primary laryngectomy was effective in 82% of glottic, 70% of supraglottic, and only 59% of transglottic carcinoma. Concerning primary tumour extension at the time of surgery, total laryngectomy proved effective in 85% of T2 tumours, 81% of T3, and only 55% for T4. The higher recurrence rates for supraglottic and transglottic tumours seem related mainly to the higher rates of cervical lymph node metastasis at diagnosis. The majority of tumour recurrences were observed during the first two years of post-operative follow-up. Thus, 76% of the 308 patients remained disease-free after the first year of post-operative follow-up, 68% after the second year, and 67% after the fifth follow-up year. Of the 96 recurrences documented until now, 91 were loco-regional (19 at the tracheostomy), and only 5 involved distant metastases. Sixteen of the 308 patients (5%) subjected to total laryngectomy have since developed second primary neoplasms, most often involving the lungs (10 patients). CONCLUSIONS: Prognostic factors for recurrence following total laryngectomy include: performance of total laryngectomy as salvage surgery, degree of tumour extension, infiltration of cervical lymph nodes at the time of initial diagnosis, poor initial tumour differentiation and trans-glottic/sub-glottic tumour localization.

Disease-Free Survival↗

PubMed1992

[Imaging procedures in diagnosis of laryngeal cancer with special reference to high resolution ultrasound].

Sonography was compared with operative and histological results in 42 patients with advanced laryngeal cancer. Sonography was accurate in the imaging of supraglottic tumours. Infiltration of the base of the tongue (n = 4) and of the pre-epiglottic space (n = 12), as well as of the thyroid cartilage (n = 8) and subglottic extensions (n = 3) were visualized too. Infiltration of the piriform sinus was correctly assessed sonographically in 8 patients. Endoscopy was superior to sonography in endolaryngeal delineation of the tumour, with in exception of paraglottic tumours. In cervical lymph node staging sonography was more accurate than palpation (86% versus 69%). The diagnostic capabilities of sonography were compared with computed tomography and magnetic resonance imaging (MRI). Due to its widespread availability and high accuracy in the delineation of supraglottic and extralaryngeal extensions and in cervical lymph node staging, sonography can be performed as primary imaging modality in advanced laryngeal cancer. If it is not possible to obtain complete delineation of the tumour by sonography, MRI must be undertaken.

Carcinoma, Squamous Cell↗

PubMed2004

Supracricoid laryngectomy: oncological and functional outcome.

OBJECTIVES: The aim of this study was to evaluate the oncological outcome and postoperative course, mortality, morbidity, and functional results of supracricoid laryngectomy (SCL). PATIENTS AND METHODS: The study included 15 consecutive patients who underwent SCL for primary laryngeal squamous cell carcinoma and had a follow-up period of more than two years. Unilateral arytenoidectomy was required in seven of the SCLs. All of the patients with supraglottic tumors and the patients with glottic T2-3 tumors underwent neck dissection in the same session with SCL. Adjuvant radiotherapy was applied in two patients with pN2 and pN3, respectively. RESULTS: The mean time for starting oral feeding was 6 days (range 3-10 days) and the time for adequate oral taking was 12.5 days (range 7-25 days). Nasogastric tube was removed between the seventh and 49th postoperative days (mean 15.7 days). All the patients were decannulated successfully in 10 to 38 days (mean 18 days) and had a satisfactory swallowing, a well-understood speech, and an intelligible voice quality. The hospitalization period was 12 to 46 days (mean 23.4 days). The durations of adequate oral feeding, nasogastric tube removal, decannulation, and hospitalization were longer in patients with one arytenoid preserved than those with bilateral arytenoids preserved, but the difference was not statistically significant. Postoperative complications were observed in three patients. Wound infection was found in two patients in the early postoperative period. One patient with a T3 supraglottic tumor that involved the medial wall of the pyriform sinus developed aspiration pneumonia twice in six months after the first operation. This patient underwent total laryngectomy seven months after the first operation. Recurrences and mortality did not occur in the follow-up period. The mean follow-up of the patients was 50.3 months (range 26-80 months). CONCLUSION: Supracricoid laryngectomy has obvious functional advantages over total laryngectomy with similar local control rates.

Aged↗

PubMed2005

[Surgery on laryngeal carcinoma--retrospective analysis of 205 cases].

OBJECTIVE: To evaluate the results of surgery for laryngeal carcinoma. METHODS: A retrospective analysis of long-term therapeutic effect was made on surgery of 105 patients with laryngeal carcinoma in the past 15 years. There were 197 males, 8 cases of female. Tumor stage were included 3 cases of Tis NOMO, 45 cases of T1NOM0, 1 case of T1N1M0, 88 cases of T2NOM0, 3 cases of T2N1M0, 1 case of T2N2M0, 33 cases of T3NOM0, 7 cases of T3N1M0, 3 cases of T3N2M0, 13 cases of T4NOM0, 6 cases of T4N1M0, 1 case of T4N2M0 and 1 case of T4N3M0. Different kinds of operations were as follows: cordectomy (1 case) or stripping (2 cases) by suspended laryngoscope, laryngofissure (9 cases), vertical partial laryngectomy without tracheotomy (16 cases), vertical partial laryngectomy (25 cases), horizontal laryngectomy (7 cases), Arslan's procedure (15 cases), cricohyoidoepiglottopexy (57 cases), subtotal laryngectomy (16 cases) and total laryngectomy (57 cases). RESULTS: There were only four missing cases among all 205 cases. The 3- and 5-year survival rate for glatt and carcinoma is 91.3% and 84. 7% respectively. The 3- and 5-year survival rate for supraglottic carcinoma is 67.5% and 65.0% respectively. Statistical differences were noted between survival rate of glottic and supraglottic carcinoma and between early and advantage disease. The overall 3- and 5-year survival rate is 84.8% and 79.4% respectively. The rate of surgical preservation of laryngeal function is 72.7%. CONCLUSIONS: The prognosis factors of laryngeal cancer were tumor stage, subsite, neck metastasis. All patients treated with different surgical techniques had fairly good quality of functional results. It is possible to preserve the laryngeal function by proper indication, safe margin, combined radiotherapy without compromising survival.

Adult↗

PubMed1992

Influence of CT on tumor classification of laryngeal carcinomas.

The routine use of CT in 51 consecutive patients with squamous cell carcinoma of the larynx revealed cartilage involvement or extralaryngeal tumor growth consistent with a T4 tumor which made 14 patients candidates for laryngectomy. Only 5 of these had a T4 classification by clinical examination while 8 cases were upstaged from T3. Except for one supraglottic tumor upstaged from T2 to T4, CT did not change the classification for T1 and T2 tumors, whose localization was mainly glottic, and there were 2 false-negative examinations. It is concluded that CT is mandatory only in advanced tumors of the glottic region or when the anterior commissure is involved. However, in suspected malignancies of the sub- or supraglottic regions CT should always be carried out because these patients are at an increased risk of unexpected deep tumor growth.

Adult↗

PubMed2005

Basaloid squamous cell carcinoma of the larynx: a case report.

Basaloid squamous cell carcinoma (SCC) is a very rare, high grade, and aggressive variant of SCC, with a predilection for the upper aerodigestive system. Treatment should include surgery of the primary tumor and dissection of the cervical lymph nodes, followed by radiotherapy. We present a 50-year-old man with basaloid SCC of the supraglottic larynx, which was initially misdiagnosed as SCC. Supraglottic laryngectomy with bilateral radical neck dissection was performed, and radiotherapy was applied postoperatively. During a follow-up of 26 months, no evidence for recurrence was found. Basaloid SCC should be considered in the differential diagnosis of upper aerodigestive system malignancies because it has a distinct prognostic significance compared to conventional SCC.

Carcinoma, Basosquamous↗