Presented by AMR

ELGENDY
Medical student
E.N.T Department
 What is laryngeal cancer
• It is a disease in
which malignant
cancer cells form
in the tissues of
larynx
• It may be in one
of the following
3 sites:
1. Supraglottic
(35%)
2. Glottic (60%)
3. Subglottic (5%)
 Inicdence
• It is one of the most common
malignancies in head and neck
• More common in males than
females
• most common in smokers
• Estimated new cases and deaths
from laryngeal cancer in the
U.S.A in 2007:
New cases : 11,300
Deaths : 3.660
Gross And Microscopic Picture
 Spread
1-Direct
To adjacent areas oflarynx
To extralaryngeal structures e.g
pharynx or trachea
2-Lymphatic
Supraglottic → via UDCL.NDS
Glottic → never or rarely
Subglottic →via LDCL.NDS
3-Blood : to L L B B
 Staging of laryngeal cancer

• It is one of the most important

factors affecting the treatment
option
• There are 2 staging parameters
:
1) TNM staging system
2) Clinical staging (AJCC)
 CLINICAL STAGING
• Stage I : (tumour confined to its place)
T1,N0,MO
• Stage II : (tumour involves adjacent
subsites)
T2,N0,M0
• Stage III : ( tumour involves adjacent
sites)
T3,N0,M0 OR T1-3,N1,MO
• Stage IV : (extention of tumour to the
whole larynx and surrounding tissues)
T4,N0-1M0 →A
T1-4,N2,MO →A
T1-4,N3,M0 →B
T1-4,N0-3,M0 → C
 Diagnosis
• Clinical picture
• Examination by laryngeal mirror
or endoscopy
• Investigation by:
1. C.T SCAN
2. MRI
3. Barium swallow
4. Biopsy by endoscope
Laryngeal mirrors
Rigid laryngoscope
Treatment option overview

Main lines of
treatmnet

Other lines still under

clinical trials
 Factors Affect Prognosis (Chance Of
Recovery) And Treatment Options
Prognosis (chance of recovery) depends on the following:
• The stage of the disease.
• The location and size of the tumor.
• The grade of the tumor.
• The patient's age, gender, and general health, including
whether the patient is anemic.
Treatment options depend on the following:
• The stage of the disease.
• The location and size of the tumor.
• Keeping the patient's ability to talk, eat, and breathe as
normal as possible.
• Whether the cancer has come back (recurred).
Smoking tobacco and drinking alcohol decrease the
effectiveness of treatment for laryngeal cancer. Patients
with laryngeal cancer who continue to smoke and drink are
less likely to be cured and more likely to develop a second
tumor. After treatment for laryngeal cancer, frequent and
careful follow-up is important.
 Treatment options
according to clinical
staging
Stage I
StageII
Stage III
Stage IV
Reccurent laryngeal cancer
• Radiation therapy with high dose
• If failed do partial laryngectomy
• If reccurence → repeat surgery
and radiation
• If recurrence → total
laryngectomy with postoperative
radiation therapy
• If failed you can try a palliative
chemotherapy
laryngectomy