{"entity":{"id":"laryngeal-cancer","kind":"cancer","name":"Laryngeal and hypopharyngeal cancer","aka":["Larynx cancer","Voice box cancer","Glottic cancer","Supraglottic cancer","Hypopharynx cancer"],"tldr":"Cancer of the voice box announces itself with hoarseness and is highly curable when caught early, by laser surgery or radiotherapy that preserve the voice. Advanced disease is treated with chemoradiation to keep the larynx where possible, with total laryngectomy for the most extensive tumours or when other treatment fails.","summary":"Laryngeal squamous cell carcinoma arises in the glottis (vocal cords), supraglottis or subglottis; hypopharyngeal cancer arises just behind and below and is grouped with it. Persistent hoarseness leads to early diagnosis of glottic tumours, which are treated with transoral laser microsurgery or radiotherapy alone with excellent cure rates. Locally advanced disease is treated with concurrent cisplatin chemoradiation, established by RTOG 91-11 as the best way to keep the larynx, while tumours that have destroyed cartilage or the larynx's function are best treated with total laryngectomy and postoperative radiotherapy, followed by voice rehabilitation with a voice prosthesis. Hypopharyngeal cancer presents late, with swallowing difficulty and neck nodes, and often needs laryngopharyngectomy. Smoking cessation is the most important single intervention.","asOf":"2026-09-17","wikipedia":"https://en.wikipedia.org/wiki/Laryngeal_cancer","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Laryngeal_cancer"}],"tags":["subtype-page"],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"notes":[],"group":"head-and-neck","burden":"About 190,000 new cases a year worldwide, overwhelmingly in smokers and heavy drinkers; early vocal cord cancers are cured in more than nine in ten patients, while hypopharyngeal cancer has among the worst outlooks in head and neck oncology.","subtypes":["Glottic (vocal cord) cancer","Supraglottic cancer","Subglottic cancer (rare)","Hypopharyngeal cancer (pyriform sinus, postcricoid, posterior wall)"],"biomarkers":["Stage and cartilage invasion on CT","Vocal cord mobility","Smoking and alcohol exposure","PD-L1 (recurrent disease)"],"standardOfCare":[{"setting":"Early glottic cancer","approach":"Transoral laser microsurgery or radiotherapy alone; both cure most patients and preserve the voice.","refs":["imrt-igrt","hypofractionated-radiotherapy"]},{"setting":"Locally advanced, larynx preservable","approach":"Concurrent cisplatin chemoradiation (RTOG 91-11); induction chemotherapy for selection in some centres.","refs":["cisplatin","rtog-91-11"]},{"setting":"Extensive disease or non-functioning larynx","approach":"Total laryngectomy with neck dissection and postoperative radiotherapy or chemoradiation; voice prosthesis rehabilitation.","refs":["imrt-igrt"]},{"setting":"Recurrent or metastatic","approach":"Salvage laryngectomy after radiotherapy failure; pembrolizumab-based therapy for metastatic disease (KEYNOTE-048).","refs":["pembrolizumab","keynote-048","cetuximab"]},{"setting":"Prevention","approach":"Smoking cessation and alcohol reduction; no screening programme exists.","refs":["smoking-cessation-after-diagnosis","alcohol-reduction-labelling"]}],"stateOfArt":["Larynx preservation with chemoradiation cures most locally advanced cancers while keeping the voice, but late toxicity and non-cancer deaths have tempered enthusiasm for it in the most extensive tumours.","Transoral laser surgery and single-fraction-savvy radiotherapy schedules give early glottic cancer cure rates above 90 percent.","Voice prostheses after laryngectomy restore intelligible speech for most patients."],"history":[{"year":1873,"title":"Billroth performs the first total laryngectomy","refs":[]},{"year":1991,"title":"VA Larynx trial: induction chemotherapy and radiotherapy preserve the larynx in two thirds","refs":[]},{"year":2003,"title":"RTOG 91-11: concurrent cisplatin chemoradiation best for larynx preservation","refs":["rtog-91-11"]},{"year":2013,"title":"Long-term RTOG 91-11 data show more non-cancer deaths after concurrent treatment","refs":["rtog-91-11"]}],"pipeline":[],"openProblems":["Hypopharyngeal cancer survival has barely improved.","Choosing between preservation and laryngectomy in T4 disease.","Long-term swallowing and airway function after chemoradiation.","Persistently high incidence where smoking remains common."],"parent":"head-and-neck"},"route":"/cancers/laryngeal-cancer/","neighbours":{"trial":[{"id":"keynote-048","kind":"trial","name":"KEYNOTE-048","route":"/trials/keynote-048/"},{"id":"rtog-91-11","kind":"trial","name":"RTOG 91-11","route":"/trials/rtog-91-11/"}],"technology":[{"id":"alcohol-reduction-labelling","kind":"technology","name":"Alcohol reduction, pricing and cancer warning labels","route":"/technologies/alcohol-reduction-labelling/"},{"id":"hypofractionated-radiotherapy","kind":"technology","name":"Hypofractionated radiotherapy","route":"/technologies/hypofractionated-radiotherapy/"},{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"},{"id":"smoking-cessation-after-diagnosis","kind":"technology","name":"Smoking cessation in cancer patients","route":"/technologies/smoking-cessation-after-diagnosis/"}],"drug":[{"id":"cetuximab","kind":"drug","name":"Cetuximab","route":"/drugs/cetuximab/"},{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"}],"cancer":[{"id":"head-and-neck","kind":"cancer","name":"Head and neck squamous cell carcinoma","route":"/cancers/head-and-neck/"}]}}