Epilarynx: pharynx or larynx?
BACKGROUND
As a general rule, epilarynx is studied as a part of supraglottis. On the contrary, in France, due to its particular natural history, it is often studied separately.


METHODS
To assess the value of this French classification, we compared from an epidemiologic point of view, in one study, 86 cases of epilarynx squamous cell carcinoma (SCC) with 431 oropharynx, 339 hypopharynx, and 89 vestibule SCC. In another study, we compared, from a clinical point of view, 232 epilarynx SCC with 1351 oropharynx, 652 hypopharynx, and 372 vestibule SCC.


RESULTS
Epilarynx patients appeared to be much heavier drinkers than larynx patients and similar to pharynx patients but tobacco consumption did not differ. The patterns of nodal involvement were similar for pharynx and epilarynx SCC. For stages I and II, patterns of failures were similar, but for stages III and IV, there were fewer locoregional failures in vestibule patients; distant metastases were equally frequent for these tumors. From the standpoint of multiple primaries, epilarynx SCC appeared to be more akin to pharynx than to larynx SCC with a much lower incidence of lung cancers. Finally, the outcome after treatment was different for vestibule, epilarynx, and pharynx SCC, with a 5-year survival of 43%, 27%, and 13%, respectively.


CONCLUSIONS
These data support the identification of epilarynx as a real entity that should be taken into account for stratification in clinical trials.
Head and Neck Department, Centre Oscar Lambret, Lille, France.
J L
JL
Lefebvre
E
E
Buisset
B
B
Coche-Dequeant
J T
JT
Van
B
B
Prevost
B
B
Hecquet
A
A
Demaille
D000206:Actuarial Analysis; D000428:Alcohol Drinking / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D015996:Survival Rate