EXPLORATORY SURGERY FOR ADVANCED-CARCINOMA OF THE LARYNX - A RELATIVELY SAFE APPROACH

Between the years 1970 and 1986, the author managed 132 patients with T3 glottic carcinoma. Over half of these patients were explored in an effort to safely perform subtotal laryngectomy. Twenty-seven of them w ere found to have extension of tumor that required immediate conversio n to total laryngectomy. Five-year survival rates were essentially the same for all three groups: immediate total laryngectomy, subtotal lar yngectomy, and total laryngectomy following attempted subtotal larynge ctomy. I conclude that carefully selected patients with T3 glottic can cer may be candidates for subtotal laryngectomy after surgical explora tion, since conversion to total laryngectomy yields local control rate s as satisfactory as those of initial total laryngectomy. When subtota l laryngectomy is possible, local control of tumor and recurrence rate s are as satisfactory as those of total laryngectomy.