Clinicopathological review of the invasion of advanced laryngeal carcinomas

Abstract

We reviewed 279 patients who received treatment for T3 and T4 laryngeal carcinomas at the Kurume University Hospital between 1979 and 2004. The purpose of this study was to clearly define histopathologic observation of the correlation between the cancer invasion into the laryngeal space and neck lymph node or distant metastasis. The analysis was also done using larynges from 128 patients who underwent total laryngectomy. In 80 supraglottic cancers, examined, preepiglottic space invasion was observed in 43 (54%), paraglottic space invasion was observed in 47 (59%) and cricoid area invasion was observed in 13 (16%). Pathologically, neck lymph node metastasis was observed in 39 (43%) of the 80. Distant metastasis was observed in 9 (12%) of the examined 74 cases. Preepiglottic space invasion strongly correlated with the cervical lymph node metastasis (p<0.01). Paraglottic space invasion correlated with the distant metastasis (p<0.05). Paraglottic space and cricoid area invasion strongly correlated with the distant metastasis (p<0.01). In addition, extraapsular spread correlated with the distant metastasis (p<0.05). These results indicate that neck dissection is necessary in cases with tumor invasion into the preepiglottic space. In cases with tumor invasion into the paraglottic space or extra - capsular spread, adjuvant chemotherapy should be considered. In 48 glottic cancers, preepiglottic space invasion was observed in 2 (4%), paraglottic space invasion was observed in 36 (75%), cricoid area invasion was observed in 18 (39%). Pathologically, neck lymph node metastasis was observed in 12 (25%) of the 48. Distant metastasis was observed in 9 (20%) of the examined 45 cases. Paraglottic space invasion strongly correlated with the cervical lymph node metastasis (p<0.05). Cricoid area invasion strongly correlated with the cervical lymph node metastasis (p<0.05). There was no statistically significant correlation between the carcinoma extension into the laryngeal space and distant metastasis. There was no statistically significant correlation between extra-capsular spread and distant metastasis.