Laryngeal cancer

• 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