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Laryngeal Cancer PowerPoint Presentation

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Description : This is a presentation about diagnosis, classification and treatment of laryngeal cancer

Tags : ent, oncology, cancer

Published on : Dec 21, 2020 | Views : 2245 | Downloads : 10

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CANCER LARYNX Duong Thi My Cancer larynx, Disease of ear, nose, throat, head and neck surgery
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EPIDEMIOLOGY AND HISTOPATHOLOGY AETIOLOGY ANATOMY - SUBDIVISION TNM CLASSIFICATION AND STAGING DIAGNOSIS OF LARYNGEAL CANCER TREATMENT OF LARYNGEAL CANCER
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I. EPIDEMIOLOGY AND HISTOPATHOLOGY - 2,63% of all body cancer M : F = 10:1 Age group: 40-70 - 90–95% : squamous cell carcinoma II. AETIOLOGY American Cancer Society: Cancer Facts and Figures 2008. Atlanta, Ga: American Cancer Society, 2008
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III. ANATOMY - SUBDIVISION
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IV. TNM CLASSIFICATION AND STAGING Source: AJCC Cancer Staging Manual, 6th Ed (2002)
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Source: Greene FL, Page DL, Fleming ID, et al. (editors). American Joint Committee on Cancer Staging Manual, 6th edition, New York: Springer-Verlag, 2002 IV. TNM CLASSIFICATION AND STAGING
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IV. TNM CLASSIFICATION AND STAGING
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IV. TNM CLASSIFICATION AND STAGING
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V. DIAGNOSIS OF LARYNGEAL CANCER History. “any patient in cancer age group having persistent or gradually increasing hoarseness for 3 weeks must have laryngeal examination to exclude cancer” - Other symptoms: Throat pain, dysphagia, referred pain in the ear, or mass of lymph nodes in the neck - Late feature: Weight loss, stridor, respiratory obstruction, halitosis 2. Indirect laryngoscopy - Appearance of lesion - Vocal cord mobility - Extent of disease
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3. Examination of neck - Extralaryngeal spread of disease - Nodal metastasis 4. Radiography: CT scan or MRI: - Evaluate pre-epiglottic or paraglottic space - Laryngeal cartilage erosion - Cervical node metastasis 5. Direct laryngoscopy - The hidden areas of larynx - Extent of disease 6. Supravital staining and biopsy Certain diagnostic test V. DIAGNOSIS OF LARYNGEAL CANCER
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VI. TREATMENT OF LARYNGEAL CANCER Site and extent of lesion (T) Presenceor absence of Nodes (N) Distant Metastases (M) Treatment Radiotherapy Surgery Combined therapy Organ preservation Conservation laryngeal surgery Total laryngectomy Surgery with pre- or postoperative radiotherapy Endoscopic CO2 laser excision
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GLOTTIC CARCINOMA 1. Carcinoma in situ: Transoral endoscopic CO2 laser stripping of vocal cord biopsy invasive carcinoma radiotherapy carcinoma in situ Regular follow-up.
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Invasive carcinoma T1 carcinoma Radiotherapy Excision of cord carcinoma with extension to anterior commissure carcinoma with extension to arytenoid Radiotherapy frontolateral partial laryngectomy total laryngectomy
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- Mobility of vocal cord? - Involvement of anterior commissure and/or arytenoid? T2N0 cancer Cord mobile Cord mobility impaired or Involvement of anterior commissure or arytenoid Conservation laryngectomy Total laryngectomy ± neck dissection Failure Radiotherapy Conservation laryngectomy Total laryngectomy ± neck dissection Failure Failure
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T3 total laryngectomy + neck dissection T4 combined therapy: surgery + P.R If nodes are palpable Only Palliative treatment P.R: postoperative radiotherapy T1,T2 T3,T4 Radiotherapy Total laryngectomy and P.R Subglottic cancer
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Age of patient Subglottic cancer
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Supraglottic cancer T1 T2 T3 , T4 Radiation or excised with CO2 laser Lung function good poor supraglottic laryngectomy With or without neck dissection radiotherapy total laryngectomy with neck dissection and P.R to neck
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Radiotherapy Cord mobility: normal Invade cartilage or cervical nodes: no Total laryngectomy: - T3 lesions (i.e. with cord fixed) - All T4 lesions - Invasion of thyroid or cricoid cartilage - Bilateral arytenoid cartilage involvement - Lesions of posterior commissure - Failure after radiotherapy or conservation surgery - Transglottic cancers, i.e. tumours involving supraglottis and glottis across the ventricle, causing fixation of the vocal cord
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Thanks for listening