Prognostic significance of Langerhans cell infiltration in cancer of the larynx

OBJECTIVE: Determine the effect on prognosis of Langerhans cell infiltration in cancer of the larynx. STUDY DESIGN AND SETTING: Retrospective review of 72 surgically treated patients with T1-3 lesions. The streptavidin-biotin method to determine Langerhans cell infiltration, which was graded as 1+, 2+, and 3+. RESULTS: A higher degree of Langerhans cell infiltration was significantly associated with less cervical lymph node metastasis, longer disease-free survival, less locoregional recurrence, and less clinical N-positivity ( P < 0.05). According to multivariant analysis, Langerhans cell infiltration was independently related to disease-free survival and recurrence ( P < 0.05). CONCLUSIONS: Langerhans cell infiltration is prognostically important in cancer of the larynx. More intense infiltration is significantly related to prolonged disease-free survival, less locoregional recurrence, less cervical lymph node metastasis, and less clinical N-positivity. SIGNIFICANCE: Langerhans cell infiltration may be determined on a biopsy specimen and this information may be useful in deciding about elective neck dissection. Patients with mild infiltration may have a higher risk of locoregional recurrence, shorter disease-free survival, and therefore they suggest a poor prognosis.