ENT Liu Knowledge Base Head & neck tumours · physician reviewed
Laryngeal Cancer · Symptoms & diagnosis

How is laryngeal cancer diagnosed and staged?

Reviewed: 8 November 2026 By: Xiangpeng Liu, MD Topic: Laryngeal Cancer Answer length: short, citable
Quick answer

Diagnosis requires a tissue biopsy read by a head and neck pathologist, supported by endoscopic examination and contrast CT or MRI of the neck; PET-CT is added when nodal or distant spread is suspected. Staging uses the AJCC TNM system and guides whether surgery, radiotherapy, chemoradiotherapy or systemic therapy is the primary treatment.

In detail

TNM staging separates glottic, supraglottic and subglottic primaries. Vocal cord fixation, cartilage invasion and subglottic extension upstage a tumour and reduce the chance of a functional partial laryngectomy; T4a disease with cartilage invasion is usually treated with total laryngectomy or definitive chemoradiotherapy depending on functional criteria.

Before radiotherapy, guidelines recommend a dental assessment and extraction of teeth with a poor prognosis inside the radiation field. Ask for this early: it prevents osteoradionecrosis later.

  • Flexible laryngoscopy / stroboscopy in clinic to visualise vocal cord mobility and lesion extent
  • Direct laryngoscopy and biopsy under general anaesthesia for tissue diagnosis
  • Contrast CT or MRI of the larynx and neck to assess cartilage, paraglottic space and nodes
  • FDG PET-CT and chest imaging for advanced disease; FNA of suspicious neck nodes
  • Assessment of airway, pulmonary function, nutrition, speech/swallow baseline and dental status
  • Multidisciplinary tumour board review to decide larynx preservation versus surgery

What this means in practice: this answer is part of the “Symptoms & diagnosis” section of the Laryngeal Cancer topic. If you are comparing treatment options, also read how to compare a second opinion and which records to send.

Other common questions about laryngeal cancer

See all 14 questions in this topic →

Sources for this answer

  1. NCCN Guidelines for Patients: Head and Neck Cancers National Comprehensive Cancer Network · 2025
  2. Head and Neck Cancers (patient information) US National Cancer Institute · 2025
  3. Global Cancer Observatory (GLOBOCAN 2022) International Agency for Research on Cancer / WHO · 2022 · Source of worldwide and country-level incidence and mortality estimates.
  4. Global Cancer Facts & Figures, 5th Edition (GLOBOCAN 2022 tables) American Cancer Society · 2024
  5. Nivolumab Risk Management Plan — epidemiological characteristics of SCCHN (GLOBOCAN 2022 summary) European Medicines Agency · 2025 · Reports the combined 947,211 head and neck cancer cases in 2022 and regional ASRs.
  6. Global burden and international trends in laryngeal cancer incidence (GLOBOCAN 2022 and CI5-XII) Japanese Journal of Clinical Oncology / registry-based review · 2025

Written and medically reviewed by Xiangpeng Liu, MD

Associate Chief Physician, ENT & Head/Neck Surgery · Chenzhou First People’s Hospital, Chenzhou, Hunan, China

Editorial policy & reviewer credentials · All sources

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Medical disclaimer: This knowledge base is general information for people researching head and neck tumours, not a diagnosis or treatment plan. It does not replace an examination by a qualified physician. Survival figures are population averages, not predictions for an individual. Treatment and cost estimates for China are illustrative only and must be confirmed in writing after your records have been reviewed. If you have a symptom lasting more than two to three weeks, see a doctor promptly.