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Nine hundred forty‐five patients with squamous cell carcinoma of the upper aerodigestive tract (SCC‐UADT) were treated at three University of Louisville‐affiliated hospitals from 1970 through 1979. Retrospective analysis disclosed that 33 patients (3.4%) never used tobacco. This group offers interesting contrasts to the more prevalent tobacco‐related epidermoid cancers. Cancers in nonusers of tobacco (mean age, 68 years) occurred approximately 10 years later than most epidermoid UADT cancers. Women predominated with a ratio of 2.7 to 1. Fifteen of 16 patients (94%) older than 70 years were women. Twenty‐four of 33 primary lesions (72%) were in the oral cavity and two thirds of these were staged 0, I, and II (American Joint Commission [AJC]). Of the patients younger than 70 years of age, 42% were men, 42% had non‐oral primaries, and most (74%) had advanced disease in AJC Stages III and IV. Second squamous cell primaries of the UADT developed in 6 of the 33 patients (18%) with an average of 48 disease‐free months. Five of six were oral lesions in patients with original oral primaries. Of the 16 patients older than 70 years with small, localized oral cancers, conservative surgery failed in 9 (56%). Although 4 were salvaged by re‐excision or radiation, 5 of these 16 patients in AJC Stage 0, I, and II died of this cancer (32%). The tendency for conservative initial surgical treatment in older patients is believed to be responsible for the higher than expected rate of treatment failure. An aggressive approach is recommended and further supported by the complete absence of surgical mortality in this group of patients. Cancer 55:1232‐1235, 1985.

Croup and epiglottitis continue to be potentially life-threatening diseases in children. Early distinction is imperative as definitive treatment differs significantly. To determine the correlation of various clinical features, x-rays, and laboratory tests with diagnosis and management planning, a retrospective chart analysis of 194 children with croup (N = 169) and epiglottitis (N = 25) was performed. The clinical history and physical findings were most important in differential diagnosis. Patient age, lateral neck x-ray, and white blood count (WBC) strongly correlated with diagnosis. Counter immunoelectrophoresis (CIE) results did not alter therapy. No blood cultures were positive unless the patient had: WBC over 15,000 with more than 10 stabs, WBC over 20,000, or WBC with more than 20 stabs. Ampicillin resistant H. influenzae occurred in 21% of positive blood cultures. Capillary blood gases did not correlate with clinical need for intubation. It is suggested that a selective evaluation of patients with epiglottitis and croup can be performed in a more cost-effective manner without sacrifice in patient care.