Primary carcinoma of the subglottic larynx

Primary cancer of the subglottic region is very rare and delay in diagnosis often leads to a poor prognosis. We retrospectively reviewed 49 patients with primary cancer of the subglottic larynx observed from 1969 to 1993 in the ORL Clinic of the University of Florence. This number constitutes 1.6% of all laryngeal cancers observed during this period. Four (8.2%) patients were stage T1, 13 (26.5%) T2, 27 (55.1%) T3, and 5 (10.2%) T4. Forty-one patients were eligible for assessing the disease-free five-year survival rate, 17 of whom were treated with surgery alone, 6 with radiotherapy alone and 18 with combination therapy (surgery for the primary tumor and postoperative radiotherapy for cervical nodes). The five-year survival rate for the three treatment types was 47%, 0% and 83.3%, respectively. The overall survival rate was 56.1%. Combination therapy produced a significantly higher (P = 0.001) disease-free survival than surgery alone or radiotherapy alone.