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Superficial extending carcinoma of the hypopharynx is a recently recognized form of carcinoma regarded as a possible pharyngeal counterpart to early gastric cancer and superficial esophageal carcinoma. In this study we report the radiological, clinical, and pathological features of three carcinomas of the larynx, which show architectural and histopathological features similar to those previously described in superficial extending carcinoma of the hypopharynx. These cases were singled out from a series of 37 consecutive laryngectomy specimens of primary infiltrating laryngeal carcinomas that were uniformly studied by means of a whole-organ sections technique. Pathologically, these cases showed a clearly invasive growth through the basal membrane into the lamina propria and an entire or predominant, extensive, superficial type of spread; infiltration of underlying muscle or gland structures was restricted to a few microscopic foci, regardless of the presence of lymph node metastases. The present study demonstrates that infiltrating carcinomas with a preferential superficial type of growth may also be encountered in the larynx. Differences between the histological features of these carcinomas of the larynx and the histopathological spectrum of so-called early laryngeal cancer are emphasized. [ABSTRACT FROM AUTHOR]

The clinical records of 207 patients with squamous cell carcinoma of the head and neck, diagnosed and surgically treated at the Otolaryngology Division of Pordenone General Hospital and Aviano Cancer Centre, northeast of Italy, from January 1982 to December 1987, were retrospectively reviewed to gather information on blood transfusions and other characteristics potentially related to survival. The group of patients (mean age = 59 years) included 85 cases (41%) of laryngeal cancer, 80 cases (39%) of oropharyngeal and hypopharyngeal cancer, and 34 cases (16%) of cancer of the oral cavity. Fifty-five patients (27%) did not receive any blood transfusion while 152 patients were transfused with different amounts of blood. At the univariate analysis, nodal involvement, clinical stage, type of therapy, status of surgical margins, and metastatic spread beyond the nodal capsule appeared to be significantly linked to prognosis. After adjustment for other prognostic variables, transfused patients showed a twofold higher hazard ratio as compared to nontransfused patients, but such an unfavorable predictive value should be evaluated in the context of the other prognostic correlates of cancer of the head and neck.

When resection of the posterior hypopharyngeal wall is undertaken for treatment of pyriform sinus carcinoma, a very narrow mucosal strip may be left for reconstruction. A surgical technique for carcinoma which has invaded the whole lateral hypopharyngeal wall is described. It consists of resecting half the larynx and half the hypopharynx and reconstructing the food canal using the mucosa of the unaffected half of the larynx and the remnant hypopharynx. A series of 34 patients treated by this technique is presented. No hypopharyngeal stenosis was observed. Local recurrences developed in 9 cases and distant metastases in 6. A specific disease mortality rate of 44% was encountered. At present, 15 patients are disease-free after a median follow-up of 48 months.