Carcinoma of the larynx

Clerf, Louis H.; Putney, F. Johnson; O’Keefe, John

doi:10.1288/00005537-194807000-00002

Cited by 22 publications

(6 citation statements)

References 3 publications

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“…34 Most researchers opine that the site, extent and infiltrative growth character of a tumour determine the prognosis for a patient to a higher degree than the histological differentiation stage of the t u m o~r .~~~~~ However, some believe that an undifferentiated carcinoma metastasizes fairly early and has a poor p r o g n o~i s .~~~~' Undifferentiated forms account for from 30 to 50% of the tumours in the supraglottic group and about 10% in the glottic group: the reasons for the poorer prognosis for supraglottic tumours lie not only in the dense network of lymph vessels but also the metastases induced by the anaplastic nature of the c a r c i n~m a . *~~~~ Numerous attempts have been made to correlate the microscopic appearance of a tumour with its biological behaviour and prognosis.…”

Section: Histological Patternmentioning

confidence: 99%

“…There are many difficulties inherent in these systems, including wide inter and intra-observer error by the histopathologists, and variations between different parts of the same tumour and at different t i r n e~.~~-~~ Furthermore, at any one site most tumours are of one specific type, for example most tumours of the vocal cord are well differentiated whereas supraglottic tumours are more commonly poorly differentiated. 34 Most researchers opine that the site, extent and infiltrative growth character of a tumour determine the prognosis for a patient to a higher degree than the histological differentiation stage of the t u m o~r .~~~~~ However, some believe that an undifferentiated carcinoma metastasizes fairly early and has a poor p r o g n o~i s .~~~~' Undifferentiated forms account for from 30 to 50% of the tumours in the supraglottic group and about 10% in the glottic group: the reasons for the poorer prognosis for supraglottic tumours lie not only in the dense network of lymph vessels but also the metastases induced by the anaplastic nature of the c a r c i n~m a . *~~~~ Numerous attempts have been made to correlate the microscopic appearance of a tumour with its biological behaviour and prognosis.…”

Section: Histological Patternmentioning

confidence: 99%

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Prognosis in laryngeal carcinoma: tumour factors

1990

Clin Otolaryngol

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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.

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Section: Histological Patternmentioning

confidence: 99%

Section: Histological Patternmentioning

confidence: 99%

Prognosis in laryngeal carcinoma: tumour factors

1990

Clin Otolaryngol

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“…The subject has been contsidered more fully in other countries-for instance by Brachetto-Brian and Samengo (1950) and Del Sel and Agra (1947) in the Argentine and Pricolo (1950) and Bocca (1952) in Ialy: in the United States Ogu-a and Bello (1952) advocated one-stage laryngectomy and block dissection in all cases of laryngeal cancer except the purely cordal ones. Leroy Schall (1951) and Louis Clerf (1951) have both expressed their agreement with this principle and Clerf has reported some results.…”

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confidence: 84%

Discussion on the Management of Cervical Metastases from Laryngeal Carcinoma

1953

Proceedings of the Royal Society of Medicine

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Section of Laryngology 481 punctured and vitreous had been lost. Mr. Hargrove found it difficult to remove the eye owing to the gross fracturing of the orbital floor. He repaired the lacerations of the lower lid and removed several small pieces of bone which were remnants of the orbital floor and then placed the remaining bones, namely the malar and the floor of the antrum and lateral side of the nose, into position. The skin edges were sewn together.He dealt with numerous middle face fractures in his area and had not had to use the complicated splints used by facio-maxillary units as he found that these fractures healed very quickly without deformity after bringing the fractured bones in apposition by an external approach. His Dental Surgeon colleague attended to the teeth, making sure that the patient's teeth were in correct apposition using the lower jaw. Radiologist's report (Dr. Humphrey Foy): Facial region.-There is extensive comminution of the right orbital floor, the right antrum, and the right ethmoidal region of the face. The right malar bone is extremely mobile, and is displaced downwards and rotated outwards, and resulting in a large gap at the fronto-malar suture.There is a step fracture visible on the floor of the left orbital near its junction with the lateral orbital wall.In addition, there is some fragmentation of the posterior edge of the hard palate. The nasal bones are intact. There is a large amount of haemorrhagic effusion in the ethmoidal malar region. and Radium Institute): Nowadays more and more attention is being paid to the secondary deposits in the cervical lymph nodes which may arise from carcinoma of the larynx.' I have always been interested in this subject because I have had more trouble with recurrence in the lymph nodes after laryngectomy than with local recurrence.For example, Fig. 1 shows a larynx which I removed two and a half years ago. The growth was fixed and involved the greater part of the vocal fold; the ventricle of the larynx was not involved and there was very little subglottic extension-the photograph rather exaggerates this. One year later a small lymph node became palpable deep to the sternomastoid on the same side. I treated this by a radical neck 1 I1 ' _ dissection. Microscopic examination showed that the node had been invaded by a squamous-cell carcinoma. It is now two and a half years after laryngectomy and one and a half years after the neck dissection and the patient is alive and well -but one cannot always count on such results.Another case with a similar primary growth on the vocal cord got a recurrence in the lymph nodes four months after laryngectomy. After a radical neck dissection nodes appeared on the opposite side of FIG. 1. Carcinoma of the right vocal cord.the neck and though these were treated in the same way the patient eventually died of his disease. In spite of these experiences, I believe it is exceptional to get secondary gland involvement in this type of case and I would like to make it quite clear that I do not advocate the so-called prophy...

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“…Sorenson and Gluck in their writings will attest to this. History reveals that since then Hayes Martin,31 Clerf,12 Ogura and Bello14 and more recently H. B. Or¬ ton29 have advocated radical neck dissection with total removal of the larynx in cases…”

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confidence: 99%

The Diagnosis and Treatment of Laryngeal Carcinoma: A Comparative Study of the Netherlands and the United States

Henken¹

1957

Archives of Otolaryngology - Head and Neck Surgery

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Carcinoma of the larynx

Cited by 22 publications

References 3 publications

Prognosis in laryngeal carcinoma: tumour factors

Prognosis in laryngeal carcinoma: tumour factors

Discussion on the Management of Cervical Metastases from Laryngeal Carcinoma

The Diagnosis and Treatment of Laryngeal Carcinoma: A Comparative Study of the Netherlands and the United States

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