Study of association between cancer surface area and histopathological parameters in total laryngectomy specimens

Background/Aim: Numerous histopathological parameters, such as cartilage penetration, perineural and lymphovascular invasion, presence of metastatic tissue in regional lymph nodes, extranodal extension of nodal metastases, as well as presence of cancer tissue on resection borders, are all important factors influencing survival in patients with laryngeal squamous cell carcinoma. A retrospective study was conducted in order to determine association between cancer surface area and these histopathological characteristics. Presence of extranodal extension of metastatic tissue in regional lymph nodes was also investigated. Methods: We revised 140 cases of laryngeal squamous cell carcinoma, processed after total laryngectomy, that were found in archives of Histopathology laboratory of Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia. Results: A significant difference in cancer surface area was found depending on penetration of thyroid cartilage, perineural invasion and positive resection margins. Cancers with greater surface area were more commonly of higher T stage. Metastases were found in 36 out of 72 neck lymph node samples submitted to evaluation (50%). Difference in cancer surface area was also found depending on presence of metastatic tissue in regional lymph nodes. Extranodal extension was present in 69.4% of involved lymph nodes, and it was more frequent in lymph nodes 3cm in size or larger. Conclusions: There is a significant difference in cancer surface area depending on presence of cartilage penetration, perineural invasion, presence of cancer tissue on resection borders and presence of metastases in regional lymph nodes. Bigger cancers tend to be of a bigger T stage. Extranodal extension is more common in lymph nodes 3cm in size or larger.