The Changing Demographics and Treatment of Larynx Cancer

Abstract

A dominant narrative in the treatment of larynx cancer has been balancing effective oncologic therapy with the preservation of major laryngeal functions such as breathing, swallowing, and speech. The first total laryngectomy, described by Billroth in 1873, was able to maintain the airway, and, separated the pharynx from the trachea, allowing swallowing without aspiration. 1 With modern tracheoesophageal prostheses for speech, total laryngectomy provides an oncologically comprehensive operation that facilitates safe swallowing without aspiration. For this reason, total laryngectomy remains a standard of care for advanced larynx cancer and the metric by which other therapies are measured.Despite this, the permanent tracheostoma and loss of vocal cord function has motivated interest in organ preservation since the earliest days of laryngeal surgery. Partial laryngeal surgery via a 'laryngo-fissure' or external approach was attempted as early as 1834. The first report of this technique being employed for a malignancy was described by Buck in 1853. 2 In the 20th century, improved anesthetic techniques, postoperative care, and, above all, improved selection of cases suitable for the operation, improved cure rates, with Chevalier Jackson reporting a local control rate of 82% in 1927. 3 Further refinements such as the hemilaryngectomy reported by Gluck and colleagues, 4 and the supraglottic laryngectomy described by Wilfred Trotter in 1913, modified by Justo Alonso, 5 and popularized by Som, Bocca, and Ogura, followed. The most significant problem solved by these trailblazing

ALCAM is a biomarker of tumor aggressiveness and worse prognosis in glottic laryngeal squamous cell carcinoma

“…Lymph node metastasis evaluation is one of the most informative data for the treatment planning of LSCC patients, with neck dissection being elective for earlystage disease, or in those patients with no evidence of lymph node metastasis in clinical evaluation (cN0). [13][14][15] However, some patients with glottic LSCC may have a tumor recurrence due to a non-diagnosed lymph node metastasis, impacting prognosis. 2,[16][17][18] Therefore, biomarkers capable of identifying prognostic and positive lymph node metastasis in glottic LSCC is essential for improving the risk classification of patients, and the choice of therapy modality.…”

“…Lymph node metastasis evaluation is one of the most informative data for the treatment planning of LSCC patients, with neck dissection being elective for early‐stage disease, or in those patients with no evidence of lymph node metastasis in clinical evaluation (cN0) 13–15 . However, some patients with glottic LSCC may have a tumor recurrence due to a non‐diagnosed lymph node metastasis, impacting prognosis 2,16–18 .…”

Bioinformatic analysis reveals prognostic value and immunotherapy potential of Siglec-15 in laryngeal squamous cell carcinoma

“…The occurrence of laryngeal cancers has increased by 12 % during the past 3 decades [ 3 ]. However, the 5-year survival rate of laryngeal cancer has not improved significantly in recent years despite the multimodal treatment [ 4 ].…”