Management of T3 glottic cancer

We reviewed 144 cases of T3NOMO glottic cancer. One hundred twelve patients were treated by radical radiotherapy with surgery for salvage (RRSS), and 28 patients were treated by combined preoperative irradiation and laryngectomy. Two patients underwent palliative irradiation, and two patients had surgery alone. Half of the number of patients are alive and well at five years; 30% of the patients died of glottic cancer. No significant difference in crude survival, tumor-related deaths, or deaths from surgical complications was observed between the RRSS group and the combined treatment group. The local control rate by radiotherapy was higher in female patients vs male patients (92% vs 44%); the local control rate was higher in men aged more than 60 years vs male patients who were younger than 60 years (52% vs 34%). Half of the larynges removed in the combined treatment group contained no tumor. We concluded that RRSS, because of its potential to save the larynx and voice, is the treatment of choice in female patients with T3 glottic cancer and is an acceptable alternative to combined treatment in male patients when good follow-up facilities exist.