Histologic grading of malignancy and prognosis in glottic carcinoma of the larynx

Two hundred and thirty patients with glottic carcinomas of the larynx treated at the Radiumhemmet from 1956 to 1966 by radiotherapy and followed for at least five years were investigated. Histologic grading of malignancy was made in each case by the registration of eight morphologic criteria, four representing the tumor cell population itself (structure, differentiation, nuclear polymorphism, and mitoses) and four representing the tumor host relationship (mode of invasion, stage of invasion, vascular invasion, and cellular response). There parameters were graded on the bases of a one to four point system according to arbitrary units. Multivariate analysis of the material revealed that the most important factors in the prediction of the five year result were found to be the nuclear polymorphism, mode of invasion, and total malignancy point value. The histologic grading of malignancy in this series was found to be better in the prediction of the five year result, recurrence or not, than the TNM classification.