[Prognostic significance of histologic grading in vocal cord carcinoma]

Long term results show that the behaviour of vocal cord cancer of the same size and undergoing the same therapy may vary widely. The biological behaviour of the tumour was assessed by well defined histopathological criteria of the malignancy evaluated by subserial sections on 49 previously untreated vocal cord carcinomas pT2-T4. Two parameters were related to the tumour cell population: differentiation and polymorphism, as well as the structure and margins of the tumour. Two parameters were related to the tumour-host relationship: vascular and perineural invasion and the cellular response of the host. Each parameter was given a three point score. The resulting malignancy index (total score = 10) gave a significant prediction of prognosis: patients with or without metastasis can be separated, high risk patients can be recognised early and decisions regarding treatment and follow up may be planned.