Histopathological prognostic and risk factors in patients with laryngeal neoplasms

Head and neck cancer is a public health problem, accounting for the fifth place of all human cancers. Each year in the US, 3% of new cases of cancer develop in this sphere. Histopathology of the primary tumor and/or laterocervical adenopathy is essential to establish the therapeutic strategy. Histopathological findings reveal a diagnostic certainty and also provide prognostic information.

We have prospectively studied a number of 95 patients with laryngeal neoplasms, which were treated in the ENT Clinic of Timisoara, Romania. The group of patients with neoplasic disease was subdivided into two groups: group 1 - patients with palpable laterocervical adenopathy and detected primary tumor (T+N+), and group 2 - patients without palpable laterocervical adenopathy, but with detected primary tumor (T+N0). Only patients with squamous cell carcinomas were included in this study. We assessed the following microscope parameters: neoplasm confirmation, histological type of neoplasm, the degree of tumor differentiation, intratumoral inflammatory reaction, perineural infiltration and the cell invasion in the small vessels. All patients underwent surgery.

N2 and N3 stage adenopathies were more common in patients with medium or low degree of cell differentiation; they were associated with weak inflammatory response of the primary tumor, within vascular invasion alone or associated with the perineural infiltration. N0 and N1 adenopathies were associated with average and good cell differentiation degree, with rich inflammatory infiltrate.

Histopathological examination of the primary tumor and cervical adenopathy is essential in establishing the diagnosis and the therapeutic approach. Histopathological examination offers information on the prognosis. Cell differentiation degree, inflammatory reaction and the cell invasion in the small vessels are the main prognostic factors of laryngeal neoplasms.