Clinical outcome and comparison between squamous and non-squamous cell carcinoma of the larynx

Abstract

Background: The various pathological types of non-squamous cell carcinomas (nSCCs) of the larynx accounted for about 5% laryngeal malignancies, but the knowledge regarding these pathological behaviors, therapeutic models and prognostic factors was limited.

Objectives: To investigate the clinical characteristics and the survival outcomes of nSCCs of the larynx.

Material and methods: A total of 106 patients diagnosed with laryngeal nSCC between 2003 and 2014 were retrospectively investigated from a cohort of 4,796 patients with laryngeal malignancies.

Results: Spindle cell carcinoma, malignant salivary gland carcinoma, neuroendocrine carcinoma, non-Hodgkin’s lymphomas, and carcinosarcoma accounted for the majority of the nSCCs of the larynx. In laryngeal nSCCs (excluding non-Hodgkin lymphomas), there was no significant difference in overall survival (OS) by tumor subsite (p = .818), clinical-stage (p = .051) or T stage (p = .412), but the difference in OS by N stage was statistically significant (p = .001). Upon comparison of propensity score-matched groups, the OS was longer in SCCs of the larynx (p = .0004).

Conclusions and significance: Primary nSCC of the larynx is rare, and its diagnosis depends on comprehensive immunohistochemical examination, as the clinical characteristics are non-specific compared with SCC. The overall prognosis of nSCC is relatively poor compared with that of SCC in the larynx.

Chinese abstract

背景：喉部非鳞状细胞癌（nSCCs）的病理类型约占喉部恶性肿瘤的5%, 但对其病理行为、治疗模式和预后因素的认识有限。

目的：探讨喉部非鳞状细胞癌的临床特点及生存结果。

材料与方法：回顾性分析2003年至2014年收治的4796例喉部恶性肿瘤患者中106例喉部nSCC的临床资料。

结果：梭形细胞癌、恶性涎腺癌、神经内分泌癌、非霍奇金淋巴瘤和癌肉瘤是喉部非鳞状细胞癌的主要类型。在喉非霍奇金淋巴瘤（不包括非霍奇金淋巴瘤）中, 肿瘤消退（p =.818）、临床分期（p =.051）和T分期（p =.412）的总生存率（OS）无显著性差异, 但N分期OS的差异有统计学意义（p =.001）。对倾向性评分匹配组进行比较, 喉部SCCs的总生存率（OS）较长（p = .0004）。

结论及意义：喉原发性非鳞状细胞癌少见, 其诊断依赖于全面的免疫组化检查, 其临床特征与SCC相比无特异性。与喉鳞癌相比, nSCC的总体预后较差。

Keywords:

• Laryngeal neoplasm
• non-squamous carcinoma
• diagnosis
• therapy
• outcome

Acknowledgements

The authors would like to thank Jian Zhou, Ph.D., Hongli Gong, Ph.D., and Chiyao Hsueh, MD, for their consultation on this case and contribution in reviewing patient data.

Disclosure statement

The authors declare that they have no competing interests.

Authors’ contributions

LC, WD and CL collected the patient data and were the major contributors in writing the manuscript. HL and SW reviewed all the pathologic results of nSCCs. LC, WD and MZ analyzed the data and prepared all the figures. LT, LZ and MZ conceived the study and revised the final manuscript. All authors read and approved the final manuscript.

Additional information

Funding

This study was supported by Science and Technology Commission of Shanghai Municipality (grant no. 16411950101) and Shanghai Natural Science Foundation of China (grant no. 17ZR1404700).