Laryngeal cancer

From greek.doctor
  • A cancer of older men
  • 40% of head and neck cancers
  • SCC
  • Etiology
    • Smoking
    • Alcohol
  • Types
    • Supraglottic
      • 40% of cases
      • Gives late symptoms
    • Glottic
      • Best prognosis because gives early symptoms (hoarseness)
      • Limited lymphatic drainage
      • 60% of cases
    • Subglottic
      • 1% of cases
      • Gives late symptoms
      • Dyspnoea
      • Stridor
  • Clinical features
    • Hoarseness
    • Foreign body sensation
    • Dyspnoea
    • Dysphagia
    • Stridor
  • Staging
    • TNM
      • T1 – confined to one part of larynx
      • T2 – invades another part of larynx
      • T3 – tumor confined to larynx
      • T4 – tumor invades outside the larynx
      • N1 – single regional ipsilateral lymph node
      • N3 – large regional lymph node
      • M1 – distant metastasis
    • AJCC stage
      • 0 – in situ
      • I – T1, N0, M0
      • II – T2, N0, M0
      • III – T3, N0, M0
      • IV – T4 OR N1 OR M1
  • Treatment
    • Early – radiotherapy or laser resection
    • Locally advanced cancer – radiochemotherapy or total laryngectomy
    • Advanced cancer – total laryngectomy with adjuvant radiotherapy
    • Neck dissection to remove lymph nodes is indicated if N1 is suspected