Prognosis and predictive factors

VC is characterized by a slow, locally invasive growth causing extensive local destruction if left untreated. Pure VC does not metastasize {746,1956}. In contrast, hybrid VC has the potential for metastasis and, accordingly these patients should be managed as similarly staged patients with SCC {1956}. VC has an excellent prognosis; the reported five-year survival rate for laryngeal VC is 8595% {751,1350}. Patients with VC may be treated by excision (by laser or surgery), or by radiotherapy. Although surgery is more effective, radiotherapy is an acceptable alternative for patients who are poor surgical candidates {978,1350, 1671,1956,2582}. Some reports have suggested that VC may undergo anaplastic transformation following radiotherapy. Critical review of these cases however has shown many to be unrecognized hybrid VC or other carcinomas that were inappropriately labelled as VC.

Fig. 3.14 Larynx verrucous carcinoma. Increased number of cell layers (left), with a broad pushing border of infiltration without cytologically atypical cells (right upper). Keratosis, including parakeratotic crypting is present (right lower).

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