Laryngeal preservation

Laryngeal cancer represents a major medical problem in this state. While early stage tumors are treatable with relatively low morbidity or quality of life sacrifices, advanced stage disease requires a total laryngectomy with its inherent life-style negatives. Recent advances in chemotherapy protocols, specifically induction cisplatin and 5-fluorouracil followed by radiation therapy, have ushered in the era of larynx preservation. This has apparently been accomplished without a sacrifice in survival. While these protocols are experimental, patients may be offered this option at certain centers, and prospective accrual will be important to the long-term efficacy questions of such therapy. The historical background and scientific foundations of laryngeal preservation protocols are discussed, and the relevant trials reviewed. Moreover, specific management issues are covered, and finally, current and future questions of such therapy are explored.