SUPRAGLOTTIC LARYNGECTOMY WITH POSTOPERATIVE RADIATION VERSUS PRIMARYRADIATION IN THE MANAGEMENT OF SUPRAGLOTTIC LARYNGEAL-CANCER

Purpose: The purpose of this review was to study the results of horizo ntal partial laryngectomy (HPL) for supraglottic laryngeal cancer (sta ges N-0 and N+) and the effects and morbidity of postoperative radiati on therapy (RT), especially after bilateral neck dissection, as oppose d to primary RT. Patients and Methods: Of a total of 89 patients, 26 w ere treated by HPL, 44 by primary RT, and 19 by total laryngectomy (TL ). Of the HPL patients, 19 of 26 had neck dissection, 10 were bilatera l. Twelve of the patients received postoperative RT, and 10 of 12 proc edures were combined with neck dissection. Results: When comparing the results of HPL and primary RT, the locoregional control was equivalen t for the N-0 patients, but HPL showed better results in locoregional control far the N+ patients (P <.0024). Postoperative RT with or witho ut bilateral neck dissection did not show an increase in postoperative morbidity. Conclusion: Therefore, our data suggest that there should be no hesitation in giving postoperative RT where indicated, after per forming HPL plus unilateral or bilateral neck dissection. Patients tha t are stage N-0 should receive primary RT. Copyright (C) 1996 by W.B. Saunders Company.