Laryngeal cancer natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2], Rim Halaby, M.D. [3], Faizan Sheraz, M.D. [4]

Overview

If left untreated, laryngeal cancer produces few symptoms early in the course. Once the tumor has expanded from its site of origin, it may obstruct the airway. Common complications of laryngeal cancer include airway obstruction, neck disfigurement, and voice abnormalities. The prognosis varies with the type and stage of laryngeal cancer. Stage 4 squamous cell carcinoma of larynx has the most unfavorable prognosis. The 3-year survival rate for supraglottic laryngeal cancer and T3 transglottic carcinoma are 91.7% and 73.2%, respectively.

Natural history

The natural history of laryngeal carcinoma depends on the site:^[1]

Supraglottic tumors ^[2]^[3]

More aggressive
Direct extension into the pre-epiglottic space, lateral hypopharynx, glossoepiglottic fold and the tongue base and lymph nodes

Glottic tumors ^[4]^[5]

Well differentiated
Less aggressive, they tend to grow slow
Metastasize late in the disease
Extend superiorly into the ventricular walls or inferiorly into the subglottic airway

Subglottic tumors ^[5]^[6]

Uncommon
Extends into the mediastinum

Complications

Common complications of laryngeal cancer include:^[7]^[8]

Airway obstruction
Disfigurement of the neck or face
Loss of voice and speaking difficulties
Metastasis
A small percentage of patients (5%) will not be able to swallow and will need to be fed through a feeding tube

Prognosis

The 3-year survival rate for supraglottic laryngeal cancer and T3 transglottic carcinoma is 91.7% and 73.2%, respectively^[9]
Laryngeal cancer can be cured in 90% of patients if detected early.
If the cancer has spread to surrounding tissues or lymph nodes in the neck, 50 – 60% of patients can be cured.
If the cancer has metastasized to parts of the body outside the head and neck, the cancer is not curable and treatment is aimed at prolonging and improving quality of life. After treatment, patients generally need therapy to help with speech and swallowing.^[10]

References

↑ Ferlito A (March 1995). “The natural history of early vocal cord cancer”. Acta Otolaryngol. 115 (2): 345–7. PMID 7610838.
↑ Ding W, Liu T, Liang J, Hu T, Cui S, Zou G, Cai W, Yang A (2017). “Supraglottic squamous cell carcinomas have distinctive clinical features and prognosis based on subregion”. PLoS ONE. 12 (11): e0188322. doi:10.1371/journal.pone.0188322. PMC 5695779. PMID 29155864.
↑ Bocca E (August 1975). “Supraglottic cancer”. Laryngoscope. 85 (8): 1318–26. doi:10.1288/00005537-197508000-00007. PMID 1160463.
↑ Zainuddin N, Mohd Kornain NK (2016). “Glottic cancer in a non-smoking patient with laryngopharyngeal reflux”. Malays Fam Physician. 11 (2–3): 35–37. PMC 5408877. PMID 28461858.
↑ ^5.0 ^5.1 Hinerman RW, Mendenhall WM, Amdur RJ, Villaret DB, Robbins KT (February 2002). “Early laryngeal cancer”. Curr Treat Options Oncol. 3 (1): 3–9. PMID 12057082.
↑ Sessions DG, Ogura JH, Fried MP (September 1975). “Carcinoma of the subglottic area”. Laryngoscope. 85 (9): 1417–23. doi:10.1288/00005537-197509000-00001. PMID 1177633.
↑ Jones TM, De M, Foran B, Harrington K, Mortimore S (May 2016). “Laryngeal cancer: United Kingdom National Multidisciplinary guidelines”. J Laryngol Otol. 130 (S2): S75–S82. doi:10.1017/S0022215116000487. PMC 4873912. PMID 27841116.
↑ Issa MR, Samuels SE, Bellile E, Shalabi FL, Eisbruch A, Wolf G (November 2015). “Tumor Volumes and Prognosis in Laryngeal Cancer”. Cancers (Basel). 7 (4): 2236–61. doi:10.3390/cancers7040888. PMC 4695888. PMID 26569309.
↑ Woo JS, Baek SK, Kwon SY, Jung KY, Lee J (October 2003). “T3 supraglottic cancer: treatment results and prognostic factors”. Acta Otolaryngol. 123 (8): 980–6. PMID 14606603.
↑ Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tân PF, Westra WH, Chung CH, Jordan RC, Lu C, Kim H, Axelrod R, Silverman CC, Redmond KP, Gillison ML (July 2010). “Human papillomavirus and survival of patients with oropharyngeal cancer”. N. Engl. J. Med. 363 (1): 24–35. doi:10.1056/NEJMoa0912217. PMC 2943767. PMID 20530316.

Template:WikiDoc Sources

[pmid7610838-1] Ferlito A (March 1995). “The natural history of early vocal cord cancer”. Acta Otolaryngol. 115 (2): 345–7. PMID 7610838.

[pmid29155864-2] Ding W, Liu T, Liang J, Hu T, Cui S, Zou G, Cai W, Yang A (2017). “Supraglottic squamous cell carcinomas have distinctive clinical features and prognosis based on subregion”. PLoS ONE. 12 (11): e0188322. doi:10.1371/journal.pone.0188322. PMC 5695779. PMID 29155864.

[pmid1160463-3] Bocca E (August 1975). “Supraglottic cancer”. Laryngoscope. 85 (8): 1318–26. doi:10.1288/00005537-197508000-00007. PMID 1160463.

[pmid28461858-4] Zainuddin N, Mohd Kornain NK (2016). “Glottic cancer in a non-smoking patient with laryngopharyngeal reflux”. Malays Fam Physician. 11 (2–3): 35–37. PMC 5408877. PMID 28461858.

[pmid12057082-5] 5.0 ^5.1 Hinerman RW, Mendenhall WM, Amdur RJ, Villaret DB, Robbins KT (February 2002). “Early laryngeal cancer”. Curr Treat Options Oncol. 3 (1): 3–9. PMID 12057082.

[pmid1177633-6] Sessions DG, Ogura JH, Fried MP (September 1975). “Carcinoma of the subglottic area”. Laryngoscope. 85 (9): 1417–23. doi:10.1288/00005537-197509000-00001. PMID 1177633.

[pmid27841116-7] Jones TM, De M, Foran B, Harrington K, Mortimore S (May 2016). “Laryngeal cancer: United Kingdom National Multidisciplinary guidelines”. J Laryngol Otol. 130 (S2): S75–S82. doi:10.1017/S0022215116000487. PMC 4873912. PMID 27841116.

[pmid26569309-8] Issa MR, Samuels SE, Bellile E, Shalabi FL, Eisbruch A, Wolf G (November 2015). “Tumor Volumes and Prognosis in Laryngeal Cancer”. Cancers (Basel). 7 (4): 2236–61. doi:10.3390/cancers7040888. PMC 4695888. PMID 26569309.

[pmid14606603-9] Woo JS, Baek SK, Kwon SY, Jung KY, Lee J (October 2003). “T3 supraglottic cancer: treatment results and prognostic factors”. Acta Otolaryngol. 123 (8): 980–6. PMID 14606603.

[pmid20530316-10] Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tân PF, Westra WH, Chung CH, Jordan RC, Lu C, Kim H, Axelrod R, Silverman CC, Redmond KP, Gillison ML (July 2010). “Human papillomavirus and survival of patients with oropharyngeal cancer”. N. Engl. J. Med. 363 (1): 24–35. doi:10.1056/NEJMoa0912217. PMC 2943767. PMID 20530316.

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