Laryngeal cancer is the most common malignant tumor of the upper respiratory tract, and about 90% are squamous cell carcinomas. Glottic cancer is often detected early because of hoarseness and therefore has a relatively good prognosis. Comprehensive treatment emphasizes both tumor eradication and preservation of laryngeal function.
· Smoking (the most important cause)
· Excessive alcohol consumption
· HPV infection
· Male sex and age >60 years
· Occupational exposure (asbestos, sulfuric acid mist, etc.)
· Gastroesophageal reflux disease
Tobacco and alcohol synergistically damage the laryngeal mucosa, while high-frequency mutations in genes such as TP53 lead to carcinogenesis. HPV infection can cause laryngeal cancer in non-smokers.
Persistent hoarseness lasting more than three weeks is a typical early symptom of glottic cancer. Supraglottic and subglottic cancers often have no obvious early symptoms. As the disease progresses, sore throat, dysphagia, referred ear pain, cervical lymph node enlargement, and airway obstruction may occur.
· Surgery: Early glottic cancer may be treated with transoral laser minimally invasive surgery or partial laryngectomy, preserving voice and swallowing functions. Total laryngectomy is suitable for extensive disease.
· Minimally invasive treatment: Transoral CO2 laser surgery can precisely remove tumors while preserving normal mucosa; for patients unsuitable for surgery, image-guided radiofrequency ablation or cryoablation may be used as palliative measures.
· Chemoradiotherapy: Radiotherapy alone can cure early laryngeal cancer; concurrent chemoradiotherapy is used in locally advanced disease to preserve laryngeal function.
· Targeted and immunotherapy: Immune checkpoint inhibitors are used for recurrent or metastatic cases and may prolong disease control.
· Others: Speech rehabilitation, swallowing function assessment, and nutritional support are essential throughout treatment.
Diagnosis is confirmed by direct electronic laryngoscopy with biopsy. CT and MRI assess the extent of invasion and lymph node metastasis. Chest imaging evaluates distant metastasis, and HPV testing is meaningful for prognostic stratification.