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
- Metastases, especially in bronchial carcinoma (lung cancer) or hypernephroma (renal cell carcinoma).
From. 1: TNM classification of laryngeal and hypopharyngeal carcinomas (cancer of the larynx and pharynx).
Tumor type | Stage | Description |
Glottic laryngeal carcinoma (glottic: “glottis-related”; >60%). | T1a | Tumor confined to one vocal fold |
T1b | Tumor extended to both vocal folds | |
T2 | Tumor spread to supra- or subglottic or vocal fold immobility | |
T3 | Vocal fold fixation, infiltration of the inner cortex of the thyroid cartilage or paraglottic space | |
T4a | Thyroid cartilage rupture, infiltration of cricoid cartilage, extralaryngeal (” located outside the larynx “) structures such as trachea (windpipe), esophagus (food pipe), tongue muscles, infrahyoid muscles, thyroid gland | |
T4b | Ingrowth into the prevertebral fascia or mediastinum (middle pleural space), walled around the carotid artery | |
Supraglottic laryngeal carcinoma.
(Supraglottic: “above the glottis”; >30%) |
T1 | Restriction to a partial range, no vocal fold immobility |
T2 | Invasion of at least 2 contiguous subregions without vocal fold fixation | |
T3 | Vocal fold fixation or infiltration of postcricoid region, preepiglottic or paraglottic space, inner cortex of thyroid cartilage | |
T4a | Thyroid cartilage rupture, infiltration of extralaryngeal structures such as trachea, esophagus, tongue muscles, infrahyoid muscles, thyroid gland | |
T4b | Ingrowth into the prevertebral fascia or mediastinum, encasement of the carotid artery | |
Subglottic laryngeal carcinoma (subglottic: “below the glottis”; approximately 1%). | T1 | Limitation to the subglottis |
T2 | Infiltration of the vocal folds without fixation | |
T3 | Vocal fold fixation, infiltration of internal thyroid cartilage, paraglottic space. | |
T4a | Invasion of thyroid or cricoid cartilage, infiltration of extralaryngeal structures such as trachea, esophagus, tongue muscles, infrahyoid muscles, thyroid gland | |
T4b | Ingrowth into the prevertebral fascia or mediastinum, encasement of the carotid artery | |
Hypopharyngeal carcinoma
(pharyngeal cancer) |
T1 | Restriction to a partial area, tumor diameter up to a maximum of 2 cm |
T2 | Invasion of at least 2 adjacent sections or tumor diameter greater than 2 cm to a maximum of 4 cm without hemilaryngeal fixation | |
T3 | Hemilaryngeal fixation (fixation of the hemi-larynx), tumor diameter greater than 4 cm, extension into the esophageal mucosa | |
T4a | Infiltration of thyroid gland, cricoid cartilage, hyoid bone, thyroid gland, esophageal muscles, central neck soft tissue | |
T4b | Ingrowth into the prevertebral fascia or mediastinum, encasement of the carotid artery |
Tab.2: Classification according to Union Internationale Contre le Cancer (UICC) of laryngeal and hypopharyngeal carcinomas.
Stage | T | N | M |
I | T1 | N0 | M0 |
II | T2 | N0 | M0 |
III | T1-2 | N1 | M0 |
T3 | N0-1 | M0 | |
IVa | T1-3 | N2 | M0 |
T4a | N0-2 | M0 | |
IVb | T1-4a | N3 | M0 |
T4b | N1-3 | M0 | |
IVc | T1-4 | N0-3 | M1 |