Clinical outcome of head and neck cancer patients: a comparison between ENT patients referred via the 2 weeks wait pathway and alternative routes in the UK health system.

2 weeks wait (2ww) referral was intended to improve cancer outcomes in the UK. However, a previous study found that 2ww failed to detect early stage head and neck cancer. There is no current study to examine the survival outcome of head and neck cancer patients diagnosed on 2ww and non-2ww pathways. The aim of this study is to compare the outcome of cancer patients diagnosed on these pathways. We performed a retrospective review of head and neck cancer patients diagnosed between 2009 and 2013 in the ENT Department at Mid-Yorkshire NHS Hospitals Trust. Gender, age, disease staging, treatment modalities, route of referrals along with survival data were documented. Survival analysis was performed for 2ww and non-2ww cancer patients. There were 4123 patients referred on 2ww during the study period. 147 patients were diagnosed with cancers on 2ww and 89 patients were diagnosed on non-2ww. There were no statistical differences in clinical staging (p = 0.416) and overall survival (p = 0.376) between 2ww and non-2ww patients. This study failed to demonstrate a better overall survival in head and neck cancer patients diagnosed on 2ww pathway within the ENT cohort. Current referral system needs to be refined to improve the survival outcome in head and neck cancer patients.

Paediatric granular cell tumour of the larynx: case report of laser resection with frozen section.

Granular cell tumours of the larynx are a very rare cause of persistent hoarse or husky voice in children. We report the case of a 13-year-old girl who presented with a three-year history of progressively huskier voice. We discuss the presentation, location and diagnosis of the tumour. In addition, we present a method of surgical treatment of the tumour, involving the hitherto unreported technique of laser excision and frozen section of the lesion.