Early glottic cancer: surgery or radiation therapy?

From 1970 to 1979 at the University Otorhinolaryngological Clinic, at the Radiology Institute of the University and at the Radiation Therapy Department of the Hospital of Florence, 385 early glottic cancers were treated: 300 by surgery and 85 with radiation therapy as the primary therapy. The policy of treatment in this period was in most cases surgery; those patients who could not be operated were treated with radiation therapy. The local control actuarial rates at 5 years were 85%, 70% and 65% for the T1a, T1b and T2 patients treated by surgery, and 86%, 83% and 57% for those treated with radiation therapy. Considering the surgical salvage, the actuarial results at 5 years were 95%, 86% and 71% for the group treated by surgery, and 86%, 90% and 69% for the one treated with radiotherapy. The crude results at 3 and 5 years with an analysis of failures according to treatment modalities are also reported. In our experience, cordectomy can be the treatment of choice in T1a glottic cancer, whereas radiation therapy offers better results in the T1b forms. Treatment policy is more questionable in the T2 cases.