title: Carcinoid tumor of the larynx: clinical analysis of 33 cases in Japan.
abstract: CONCLUSIONS
  In regard to the treatment of carcinoid tumor of the larynx, irradiation is not effective and tumor excision with a minimum surgical margin is associated with a high risk of local recurrence. Lymph node metastases to the neck are associated with worsening of the prognosis. To improve the survival rate, primary resection with a sufficient surgical margin (e.g. partial laryngectomy) and (elective) neck dissection is recommended, even for patients with early stage carcinoid tumors of the larynx.
  
  
  OBJECTIVE
  The objective of this study was to clarify the prognostic factors, modalities of treatment for the primary lesions, and importance of neck dissection in the treatment of carcinoid tumors of the larynx.
  
  
  METHODS
  The data of 33 cases of carcinoid of the larynx reported from Japan (including 2 of our cases) were analyzed.
  
  
  RESULTS
  The distributions of the T and N classifications of the lesions were as follows T1, 50.0%; T2, 32.2%; T3, 14.3%; T4, 3.6%; N0, 57.1%; N1, 17.9%; N2, 25.0%; and N3, 0%. Fifteen patients underwent radiation therapy, of whom five underwent curative radiotherapy. While complete remission (CR) was maintained in one of these patients (T1N0), the remaining four patients developed recurrence. Five patients underwent preoperative radiation therapy. The response to the treatment was rated as no change in four patients and as progressive disease in the remaining one patient. Among the patients with N0 disease, seven patients (43.8%) developed lymph node metastases in the neck postoperatively. Distant metastases were the most frequent cause of death in the patients. The 3-year, 5-year, and 10-year survival rates of the patients were 58.5%, 36.5%, and 12.2%, respectively. Significant differences were recognized in the survival rates between patients with and without neck lymph node involvement at the first treatment (p=0.008), and between patients with and without postoperative lymph node recurrence in the neck (p=0.037).
authors.affiliation: Department of Otorhinolaryngology, University of Tokyo, Tokyo.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ebihara
authors.forename: Kenta
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Fujishiro
authors.forename: Kazunari
authors.initials: K
authors.lastname: Nakao
authors.forename: Seiichi
authors.initials: S
authors.lastname: Yoshimoto
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kawabata
authors.forename: Takahiro
authors.initials: T
authors.lastname: Asakage
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002276:Carcinoid Tumor / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D018278:Carcinoma, Neuroendocrine / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007564:Japan; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D007825:Laryngectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D009367:Neoplasm Staging; D016879:Salvage Therapy / Q000379:methods*; D015996:Survival Rate