Treatment of laryngeal cancer: endoscopic surgery or cricohyoidoepiglottopexy versus radiotherapy

Introduction: Both radiotherapy and endoscopic or open functional surgery a re recognised treatments for laryngeal cancer stage I and II. A comparison between two groups of patients treated with either modality may clarify the indications for both treatments. Methods: Over a period of 13 years two separate series of patients were tre ated for laryngeal cancer (stage I and II) by either surgery (n = 72) or ra diotherapy (n = 81). We have analysed and compared the two groups. Results: Statistical analyses show a better local control among patients tr eated with surgery, when the anterior commissure was involved (T1b) or with extension of the tumour (T2). However, long-term survivals were not signif ically different in the two groups. As postradiation recurrence was diagnos ed at an early stage, salvage (requiring total laryngectomy in many cases) was efficient but contributed to an appreciable difference in the long-term laryngeal preservation rate between the two groups (91% after radiotherapy and 99% after surgery). Conclusion: The treatment of laryngeal cancer must always compromise betwee n oncological efficiency and functional preservation. With anterior commiss ure involvement (T1b) or more extensive disease (T2), surgery appears to be better. Therefore, preservation of perfect laryngeal function should be su bordinate to oncological safety.