# Laryngeal and hypopharyngeal cancer

Source: https://onco.cc/cancers/laryngeal-cancer/  
OnCo record `laryngeal-cancer` (Cancer). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Cancer of the voice box, a head and neck cancer, 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.

## Fields

- Kind: Cancer
- Last checked: 2026-09-17
- Also known as: Larynx cancer; Voice box cancer; Glottic cancer; Supraglottic cancer; Hypopharynx cancer
- Tags: subtype-page
- 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)

## Sections of this record

The page is a hub with ten sections in reading order; large sections have their own page. The same plan as JSON: https://onco.cc/api/v1/cancers/laryngeal-cancer/sections.json

- Overview (on the hub): The TL;DR, the family this cancer belongs to, the organ, who gets it and what the state of the art is. https://onco.cc/cancers/laryngeal-cancer/#overview [1 subtype, 3 state-of-the-art points]
- Types and stages (on the hub): Anatomy, the subtypes and how they differ, how it is staged, and where advanced disease spreads. https://onco.cc/cancers/laryngeal-cancer/#what-it-is [5 subtypes]
- Symptoms and diagnosis (on the hub): How this cancer shows itself, how the diagnosis is confirmed, and the biomarkers clinicians test for. https://onco.cc/cancers/laryngeal-cancer/#finding-it [4 biomarkers]
- Treatment (on the hub): The standard of care by setting, the medicines, surgery and radiotherapy named in it, and the regimens behind them. https://onco.cc/cancers/laryngeal-cancer/#treating-it [5 settings, 3 decisions with options]
- Trials and papers (on the hub): Trials recruiting now, the landmark trials, the trials held by this cancer's subtypes, the key papers and what they mean, the latest literature, and the milestones year by year. https://onco.cc/cancers/laryngeal-cancer/#evidence [3 trials, 5 key papers, 4 milestones]
- Biology and targets (on the hub): The molecular landscape: the targets and how often each appears, the pathways, the mechanics stages and the preclinical models. https://onco.cc/cancers/laryngeal-cancer/#science [2 targets]
- Countries and centres (own page): Cases by country, the UK and NHS pathway and other country lenses, the expert centres with trials on record, and the centres named on this cancer's subtypes. https://onco.cc/cancers/laryngeal-cancer/where-you-are/ [11 centres in the subtypes]
- Decisions and support (on the hub): The decisions you may face, the aids that walk through them, the warnings on record, the first sixty days and the questions to ask. https://onco.cc/cancers/laryngeal-cancer/#living-with-it [18 questions, 6 red cards]
- Pipeline and open problems (own page): Everything in development, the medicines held by this cancer's subtypes, the open problems and what is being done about them, the roadmaps, and what changed on this record. https://onco.cc/cancers/laryngeal-cancer/coming/ [3 medicines, 3 medicines in the subtypes, 3 trials, 4 open problems]
- Data (own page): Every connected record, the notes, the JSON, Markdown and RDF twins, and where the record came from and when it was checked. https://onco.cc/cancers/laryngeal-cancer/data/ [29 connected records]

## Standard of care

- Early glottic cancer: Transoral laser microsurgery or radiotherapy alone; both cure most patients and preserve the voice. ([IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/), [Hypofractionated radiotherapy](https://onco.cc/technologies/hypofractionated-radiotherapy/))
- Locally advanced, larynx preservable: Concurrent cisplatin chemoradiation (RTOG 91-11); induction chemotherapy for selection in some centres. ([Cisplatin](https://onco.cc/drugs/cisplatin/), [RTOG 91-11](https://onco.cc/trials/rtog-91-11/))
- Extensive disease or non-functioning larynx: Total laryngectomy with neck dissection and postoperative radiotherapy or chemoradiation; voice prosthesis rehabilitation. ([IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/))
- Recurrent or metastatic: Salvage laryngectomy after radiotherapy failure; pembrolizumab-based therapy for metastatic disease (KEYNOTE-048). ([Pembrolizumab](https://onco.cc/drugs/pembrolizumab/), [KEYNOTE-048](https://onco.cc/trials/keynote-048/), [Cetuximab](https://onco.cc/drugs/cetuximab/))
- Prevention: Smoking cessation and alcohol reduction; no screening programme exists. ([Smoking cessation in cancer patients](https://onco.cc/technologies/smoking-cessation-after-diagnosis/), [Alcohol reduction, pricing and cancer warning labels](https://onco.cc/technologies/alcohol-reduction-labelling/))

## State of the art

- 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.

## Open problems

- 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.

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Laryngeal_cancer
- Wikipedia: https://en.wikipedia.org/wiki/Laryngeal_cancer

## Connected records

- cancers: [Head and neck squamous cell carcinoma](https://onco.cc/cancers/head-and-neck/), [HPV-negative head and neck squamous cell carcinoma (including HPV-negative oropharyngeal cancer)](https://onco.cc/cancers/hpv-negative-head-and-neck-cancer/), [Hypopharyngeal cancer](https://onco.cc/cancers/hypopharyngeal-cancer/), [Oral cavity cancer (mouth and tongue)](https://onco.cc/cancers/oral-cavity-cancer/), [Oropharyngeal cancer (tonsil and base of tongue)](https://onco.cc/cancers/oropharyngeal-cancer/), [Recurrent or metastatic head and neck squamous cell carcinoma](https://onco.cc/cancers/recurrent-metastatic-hnscc/)
- key papers: [Department of Veterans Affairs Laryngeal Cancer Study: induction chemotherapy plus radiation versus surgery plus radiation](https://onco.cc/key-papers/paper-va-larynx-induction-chemotherapy-nejm-1991/), [EORTC 24891: larynx preservation with induction chemotherapy in pyriform sinus (hypopharyngeal) cancer](https://onco.cc/key-papers/paper-eortc-24891-larynx-preservation-lefebvre-jnci-1996/), [KEYNOTE-048: pembrolizumab, alone or with chemotherapy, as first treatment for recurrent or metastatic head and neck cancer](https://onco.cc/key-papers/paper-keynote-048-lancet-2019/), [Long-term results of RTOG 91-11: three non-surgical strategies to preserve the larynx](https://onco.cc/key-papers/paper-rtog-91-11-long-term-forastiere-jco-2013/), [RTOG 91-11: concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer](https://onco.cc/key-papers/paper-rtog-91-11-forastiere-nejm-2003/)
- trials: [Bonner trial (cetuximab plus radiotherapy)](https://onco.cc/trials/bonner-cetuximab-rt/), [KEYNOTE-048](https://onco.cc/trials/keynote-048/), [RTOG 91-11](https://onco.cc/trials/rtog-91-11/)
- drugs: [Cetuximab](https://onco.cc/drugs/cetuximab/), [Cisplatin](https://onco.cc/drugs/cisplatin/), [Pembrolizumab](https://onco.cc/drugs/pembrolizumab/)
- technologies: [Adaptive radiotherapy (online replanning)](https://onco.cc/technologies/adaptive-radiotherapy/), [Alcohol reduction, pricing and cancer warning labels](https://onco.cc/technologies/alcohol-reduction-labelling/), [Head and neck reconstruction: the free flap, and what it gives back](https://onco.cc/technologies/rejuv-recon-head-neck/), [Hypofractionated radiotherapy](https://onco.cc/technologies/hypofractionated-radiotherapy/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/), [Smoking cessation in cancer patients](https://onco.cc/technologies/smoking-cessation-after-diagnosis/), [Swallowing therapy around head and neck radiotherapy](https://onco.cc/technologies/rejuv-rehab-swallowing/), [The devices that do the restoring, and who pays for them](https://onco.cc/technologies/rejuv-rehab-assistive-devices/), [Voice after the larynx is removed](https://onco.cc/technologies/rejuv-recon-voice-after-laryngectomy/)

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JSON: https://onco.cc/api/v1/entities/laryngeal-cancer.json