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Head Neck. 2018 Jun 26. doi: 10.1002/hed.25172. [Epub ahead of print]

Prognosis of subglottic carcinoma: Is it really worse?

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Department of Otolaryngology - Head and Neck Surgery, Uludag University School of Medicine, Bursa, Turkey.
Department of Radiation Oncology, University of Florida, Gainesville, Florida.
University of Udine School of Medicine, Udine, Italy.
Department of Otolaryngology, Hospital Universitario Central de Asturias, IUOPA, University of Oviedo, Centro de Investigación Biomédica en Red de Cancer (CIBERONC), Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias and Centro de Investigación Biomédica en Red de Cancer (CIBERONC), ISCIII, Oviedo, Spain.
Instituto Universitario de Oncología del Principado de Asturias, University of Oviedo, Oviedo, Spain.
Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, Georgia.
Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Radiation Oncology, The Prince of Wales Cancer Centre, Sydney, New South Wales, Australia.
Department of Otolaryngology - Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Coordinator of the International Head and Neck Scientific Group.


It is traditionally accepted that subglottic carcinoma has a worse prognosis than tumors arising in other subsites of the larynx, owing to its tendency to present in advanced stages, with a high incidence of cartilage invasion and extralaryngeal spread. The incidence of subglottic carcinoma varies among series, mainly because there is no uniform definition of the upper boundary of the subglottis. The extent of the tumor may be difficult to define because subglottic carcinoma may spread through the submucosa without visible mucosal changes. There is also a rich lymphatic network in the subglottis draining to the prelaryngeal and paratracheal lymph nodes, which are usually not involved by cancers arising in other laryngeal subsites. Current literature data indicates that early-stage subglottic carcinoma can be treated using radiotherapy or chemoradiotherapy with high locoregional control and survival rates. In advanced stage subglottic carcinoma, combination of surgery followed by radiotherapy or chemoradiotherapy resulted in comparable outcomes, as in advanced carcinomas from the rest of the larynx. Stage for stage, it is likely that the prognosis for subglottic carcinoma and of glottic and supraglottic cancers is similar.


larynx; prognosis; squamous cell carcinoma; subglottic cancer; therapy


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