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