Abstract
The author made investigations on 40 cases of total extirpation of laryngeal carcinoma consisting of 19 cases operated at Department of Otorhiro-laryngology, Nihon Medical College and 21 cases of Massachusetts Eye & Ear Infirmary where he had studied. The studies were done on types of the carcinoma which had influence on postoparative prognosis, invasive range of the carcinoma, histological malignancy, whole histological construction and metastasis to the lymph nodes.
1. As for the relation between invasive range and postoperative recidivation, recurrence was increasingly frequent as the stage of the disease went on. The data obtained were as follows: Stage I -16.6%, Stage II -33.3%, Stage III-41.7%, Stage IV-60.0%.
2. The results of studies on relation between types of the carcinoma and postoperative recidivation revealed that rate of recurrence was 21.6% in glottic type, 41.7% in subglottic type and 55.5% in supraglottic type, showing low frequency in glottic type and high frequency in subglottic and supraglottic types in comparison with glottic type. No definite difference between rate of recurrence in subglottic type and that in supraglottic type was seen.
3. The author confirmed on total sections of laryngeal cardinoma that keratinization, presence of intercellular bridge, number of pictures of karyokinesis, and polymorphism of cells and nuclei were closely connected with postoperative recidivation, and thus established the standards in judgement of malignancy to presume prognosis histologically. This method seemed to be more complete than Broders'.
4. Results of examination on total sections showed that the histological pictures were rich in regional variety. Therefore, such pieces of tissue as obtained by biopsy were to small to understand the whole histological manifestations.
5. For this reason, carcinoma alveoli were classified according to types of carcinomatous development. Postoperative recidivation was more frequent in mushrooming type than in extending type or hypertrophic type. Type of intravascular development was seen in 5 cases complicating mushrooming type and all of them died of postoperative recidivation showing high rate of recurrence.
6. The whole histological constructions of the carcinoma including developing types and size of carcinoma alveoli, and inflammatory cell infiltration were classified in 3 types. The rate of recurrence was high in mushrooming type of small carcinoma alveoli.
7. Postoperative prognosis of laryngeal carcinoma from the histological viewpoint should be judged not only from the promary focus, but also from the metastatic foci. The regional lymph nodes began to prepare themselves to metastasis when inflammatory change of carcinomatous foci came to involve them.
