OUTCOME OF OPEN SURGICAL THERAPY FOR GLOTTIC CARCINOMA

A retrospective review was undertaken of the medical records of 270 pa tients with carcinoma of the glottic larynx. Patients were staged path ologically, and clinical pathologic correlates were made with outcome. In 92 patients with early glottic cancer, the 2-year rate of no evide nce of disease for T1 was 98%, and for T2, 84%. Vertical partial laryn gectomy resulted in voice preservation in 89%. Patients treated for ad vanced (T3 or T4) glottic carcinoma underwent total laryngectomy with or without neck dissection. Cervical nodes were involved in 22% of T3 and 41% of T4 patients at the time of treatment Survival with no evide nce of disease was chiefly determined by the development of regional r ecurrence, distant metastasis, and new primary cancer. Distant metasta sis was associated with extracapsular spread (p = .003). Patients trea ted for T4 glottic carcinoma with neck dissection had improved surviva l compared with patients with laryngectomy alone (p = .006). Improved survival must be aimed at regional control, prevention, and management of distant metastasis and new primary carcinoma.