LI-treated OSCC patients were characterized by a markedly altered composition of tumor-infiltrating mononuclear cells, increased CD4+:CD8+ ratio, and increased tumor stroma to epithelial ratio, all of which were distinct from controls.

Treatment of lymph node negative (N0) glottic carcinoma has raised numerous controversy for decades. Prevention is one of the oldest axioms in medicine. On the other hand, overtreatment can cause unnecessary harm to patients. This retrospective study was performed in 206 patients having glottic cancers with clinically node-negative (N0) necks. The aim of this assessment is to deal with the diagnosis, predictive factors and surgical therapy of occult metastases of squamous cell cancers originating from the glottic region. The examinations were performed in three phases. Preoperative clinical, histological - and in selective cases - imaging were carried out to separate high-risk patients. Intraoperative cases of open surgery after U-shaped skin preparation up to the hyoid bone with direct inspection of jugular lymph node chain (JLNCh) where the neck was staged. The enlarged suspicious nodes were submitted for immediate frozen section. The types of neck dissection were based on the size, shape, number and histological diagnosis of regional nodes. The postoperative additional management was decided according to the results of definitive pathological findings from serial sections of the dissected specimen. Endolaryngeal LASER surgery was carried out in 87 patients based on clinical, histological and imaging criteria. In the course of two years follow-up 2 occult metastases became clinically apparent. At 119 cases open surgery were performed. In 51 patients we could not see enlarged lymph nodes (N< 2 mm) with direct examination, and thus the JLNCh remained intact. In 68 patients elective neck dissections (END) were carried out. In cases of extracapsular spread (ECS) and/or multiple nodal involvements additional radiotherapy was given.

Previous experience has shown that conservation of the healthy hemilarynx is possible for the treatment of extended lateralized laryngeal and hypopharyngeal cancers. One major indication for supracricoid hemilaryngectomy is glottic cancer involving either the arytenoid or Morgagni's ventricle. Hemilaryngopharyngectomy is also indicated when tumor of the pyriform sinus involves its anterior part, lateral wall, medial wall and ary- and pharyngoepiglottic folds. Supracricoid hemilaryngopharyngectomy was performed in seven cases. The resection consisted of removal of the surpacricoid hemilarynx and ipsilateral pyriform sinus. The reconstruction was performed by elevating the posterior pharyngeal wall and suturing the mucosa to the midline. This surgical technique provided good functional results. Patients had no airway impairments, but the recovery of satisfactory deglutition may require 14-32 days. Phonatory rehabilitation was successful, and each patient had a satisfactory vocal quality. Postoperative irradiation did not affect the functional results.