Therapeutic targets Cure or slowing of tumor growth. Palliative (palliative treatment) Therapy recommendations First-line methods are surgery and radiotherapy. The latter is often performed as radiochemotherapy (RCTX). Primary radiochemotherapy, followed by salvage surgery if necessary. Cytostatic therapy: induction chemotherapy ( form of chemotherapy initially aimed at acute reduction of tumor volume or tumor cell count) … Laryngeal Cancer: Drug Therapy
Mandatory medical device diagnostics. Laryngoscopy (indirect laryngoscopy) – at initial diagnosis. Laryngeal stroboscopy – at initial diagnosis (assessment of vocal fold function during phonation: regular stroboscopic examinations allow early detection of infiltrative vocal fold processes. Mucosal changes that infiltrate the vocal fold muscles lead to a stroboscopic (phonatory) arrest. If this stagnation persists for 2-3 … Laryngeal Cancer: Diagnostic Tests
Medical history (history of illness) is an important component in the diagnosis of laryngeal carcinoma (cancer of the larynx). Family history Are there any tumor cases in your family that are common? Social history What is your profession? Are you exposed to harmful working substances in your profession? Is there smoking in your environment, i.e. … Laryngeal Cancer: Medical History
Respiratory System (J00-J99). Chronic laryngitis (inflammation of the larynx). Neoplasms – tumor diseases (C00-D48). Hypopharyngeal carcinoma (cancer of the pharynx).
The following are the most important diseases or complications that can be caused by laryngeal carcinoma (cancer of the larynx): Neoplasms – Tumor Diseases (C00-D48). Metastasis Lymph nodes Lungs Prognostic factors Tracheotomy (tracheotomy ) performed before laryngectomy (laryngectomy) negatively affects prognosis because stoma recurrence (recurrence of disease at the surgically created opening of the trachea) … Laryngeal Cancer: Complications
Laryngeal carcinoma is classified as follows: According to location Supraglottic (“above the glottis”; > 30%). Glottic (“glottis-related”; > 60 %) Subglottic “below the glottis”; (circa 1%). Hypopharyngeal carcinoma ( “cancer of the pharynx”). According to histology Squamous cell carcinoma (> 90 %) Adenocarcinoma Adenoid cystic carcinoma Small cell carcinoma Neuroendocrine carcinoma Melanoma Sarcoma Malignant lymphoma … Laryngeal Cancer: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Pharynx (throat) Inspection and palpation (palpation) of the lymph node stations (cervical, axillary, supraclavicular, inguinal). ENT medical examination – including laryngoscopy (laryngoscopy) including stroboscopy. Health … Laryngeal Cancer: Examination
Biopsy A biopsy (tissue removal) should be performed as an excisional biopsy. That is, small circumscribed malignancy-specific mucosal lesions should be completely removed. Primary tumor treatment Laryngeal carcinoma is operated on if the tumor is resectable, that is, R0 resection (removal of the tumor in healthy tissue; no tumor tissue is detectable in the resection … Laryngeal Cancer: Surgical Therapy
To prevent laryngeal cancer (cancer of the larynx), attention must be paid to reducing individual risk factors. Behavioral risk factors Consumption of stimulants Alcohol Tobacco (smoking, passive smoking) Environmental pollution – intoxications (poisonings). Occupational exposure to asbestos* or tar/bitumen. Ionizing radiation (e.g. uranium* ). Polycyclic aromatic hydrocarbons (PAHs), e.g. benzo(a)pyrene. Sulfur-containing aerosols, intensive and multi-year … Laryngeal Cancer: Prevention
Overview Standards of therapy for laryngeal carcinoma [see S3 guideline below]. T category Partial resection (TR)TLM* , TORS* * , open TR Laryngectomy Radiation/multimodal organ preservation Supraglottic carcinoma T1 x x T2 x (x) Individual cases x T3 x x x T4a (x) Individual cases x x T4b* x Prim. Radiochemotherapy Glottic carcinoma T1 x … Laryngeal Cancer: Radiotherapy
The following symptoms and complaints may indicate laryngeal cancer (cancer of the larynx): Symptoms-usually appear late Dysphonia (hoarseness)* – relatively early symptom in vocal fold carcinoma (see below). Dyspnea (shortness of breath) Rough voice Dysphagia (difficulty swallowing/swallowing). Cough irritation Feeling of pressure in the throat Stitches to the throat Lymphadenopathy (enlargement of lymph nodes) Note: … Laryngeal Cancer: Symptoms, Complaints, Signs
Pathogenesis (development of disease) In laryngeal carcinoma (cancer of the larynx), malignant transformation of the squamous epithelium occurs in more than 90% of cases. It usually develops because of previous damage to the larynx, called precancerous lesions. Precancerous lesions include dysplasia (precancerous lesion), leukoplakia (hyperkeratosis/excessive keratinization of the skin of the mucous membranes or the … Laryngeal Cancer: Causes
