Spindle cell carcinoma of the larynx.

Four rare cases of spindle cell carcinoma of the larynx are reported and the histo-pathological and immuno-histochemical findings are described. The spindle cell carcinoma involved the right vocal cord of an 88-year-old and an 86-year-old male patients and the anterior commissure of a 76-year-old and a 68-year-old male patients. Two patients underwent total laryngectomy, one patient extirpation under laryngomicrosurgery and one radiation therapy. All were well controlled thereafter and there was no recurrence. Surgery seemed to be the most satisfactory therapeutic approach and radiation therapy was effective in a patient with relatively small tumor. The histo-pathological and immuno-histochemical analysis in one patient revealed a sarcoma-like component of the carcinoma and the findings suggested that this was the result of a metaplastic change in the mesenchyme without inflammatory changes.

[A clinical study of 213 patients with laryngeal cancer].

We retrospectively analyzed 213 patients--197 men and 14 women aged 40 to 87 years--with laryngeal cancer treated at our department from September 1986 to December 1997. The male to female ratio was about 12:1. Cases included 120 glottic (56.3%), 90 supraglottic (42.3%), and 3 subglottic (1.4%). Radiotherapy for early cases and surgery, mainly total laryngectomy for T3 and T4 were conducted first. The 5-year cause-specific survival by site was 97.6% glottic and 77.5% supraglottic. The five-year survival was 88.6% overall. Local control was 83.8% in glottic T1a and 84.6% in glottic T1b. The 3-year preservation of the larynx was 89.1% in glottic T1a and 92.3% in glottic T1b. Distant metastases were observed in 14 cases, mostly to the lung, bones, and liver. At high risk for distant metastasis were those with supraglottic T3-T4, N1, N2b, or pN2c.