A personal series of 765 previously untreated patients with laryngeal carcinoma seen between 1962 and 1988 was analysed for the importance of prognostic factors. There were numerous significant correlations between tumour prognostic factors, particularly with neck node status. Palpable cervical nodes increased in frequency with increasing T status, and palpable lymph nodes were commoner in less well differentiated tumours, and in supra and sub-glottic tumours. These correlations were very highly significant. Increasing T stage was associated with increasing N stage. T stage was also associated with site, glottic tumours being far more likely to be T1 than supra or sub-glottic tumours. T stage was not related to histological grade. Histological grade correlated with site, glottic tumours being well differentiated much more often. When survival was analysed by univariate methods there were highly significant differences with increasing T stage and N stage, between the various histological grades and the various sites. However, when survival was analysed by multifactorial methods taking interactions into account, only N status was a significant prognostic factor. When patients with palpable nodes submitted to surgery were analysed, it transpired that clinical staging and node level were relatively unimportant compared with pathological findings: both the number of nodes invaded and the presence of tumour outside lymph nodes (extracapsular rupture) were highly significant.

The results of treatment of 82 patients with chronic laryngeal stenosis during a 20-year period are presented. Road traffic accidents accounted for 30% of the cases and iatrogenic disease for 40%. Of the stenoses 10% were supraglottic, 20% glottic, 50% subglottic, and 15% combined. Virtually all patients with supraglottic stenosis had a good result as regards voice and airway, and we describe the use of a laryngeal widening operation for this group of patients. Over 80% of patients with glottic stenosis achieved good results. However, patients with a subglottic stenosis did badly, and only 60% were relieved of their tracheostomies. Patients with stenosis due to previous tracheostomy or to systemic disease such as Wegener's granuloma did badly.

A personal series of 842 patients with a tumour of the oral cavity is presented. Five hundred and twelve of these patients had a histologically proven squamous cell carcinoma, and were previously untreated.Increasing age was associated with worsening performance status. Women were older at presentation than men, and tumours of the upper part of the mouth were more common in the elderly, but there was no relation between age and histological grade or stage grouping.Sex had no correlation with performance status or histological grade. However, men were more likely to have an advanced tumour, and tumours of the floor of the mouth and alveolus were much commoner in men.There was no correlation between performance status and site or histological grade, but patients in poor general condition were more likely to have stage III-IV tumours.Multivariate analysis showed that sex had no impact whatever on survival, but survival fell with increasing age and worsening performance status. The effect of age and performance status disappeared when the survival of treated patients was adjusted for deaths due to other causes.

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We present 70 patients with tumours of the posterior pharyngeal wall, considering tumours of the posterior hypopharyngeal and posterior oropharyngeal wall as one unit. Almost half (45%) of the patients were in poor general condition at the time of presentation, and 60% had Stage III or IV tumours. One‐third of the patients were untreated, and surgery was mainly reserved for patients with Stage I and II tumours. The larynx could be preserved in two‐thirds of those undergoing surgery. The best current method of repair of the posterior pharyngeal wall after partial pharyngectomy appears to be a revascularized radial forearm flap. The median survival for patients with Stage I tumours was 236 weeks, but for patients with Stages II‐IV tumours was only 33 weeks. There was no significant difference between the survival for II–IV stage groups, but there was between Group I and the rest. We identify 2 defects in the UICC classification system: lack of definition of the lateral limit of the posterior pharyngeal wall, and a gross discrepancy between size and T staging of tumours arising primarily from the posterior wall of the hypopharynx.