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Common symptoms are a consequence of the neoplastic mass compression or infiltration of surrounding structures, like chest or back pain, productive cough, fever, dyspnoea, weight loss and dysphagia in case of involvement of the mediastinum.
A planned complete restaging repeating all of the primary investigations (bone marrow biopsy only in case of involvement) was performed after six chemotherapy cycles (restaging 1).
The modified supracricoid laryngectomy (MSCL) with reconstruction of vocal folds results oncologically safe in case of involvement of anterior commissure without recurrence at five years and with a local control rate equal to 90.5%, also increasing the quality of voice and life than the SCL [ 4– 7].
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Sawyer et al. have tried to divide pN2 patients into three different subgroups according to their respective risk of failure: high-risk (in cases of multiple distant mediastinal nodes involved), intermediate-risk (in cases of involvement of inferior nodes or superior nodes with eventual invasion of hilar nodes).
Dermoglandular rotation mammaplasty and lateral thoracic advancement flap are predominantly performed in cases of involvement of the upper outer quadrant of the breast.
In case of bilateral involvement, the more painful leg was considered the involved leg.
In another series, 200 cases classified as T1 were treated with radiotherapy and they had a local control rate of 89% in case of commissure involvement compared to 94%, when the commissure was not involved [ 30].
In case of carina involvement, only Y silicone stents (novatech®) were used.
In case of malignant involvement only in the paraffin section, axillary dissection was performed.
In case of bony involvement, the disease has a high recurrence rate of 50%.
In case of the involvement of multiple genes, also Mal d 1.04 may play a role.
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