Primary carcinoma of the subglottic larynx

Primary cancer of the subglottic region is very rare and delay in diagnosis often leads to a poor prognosis. We retrospectively reviewed 49 patients w ith primary cancer of the subglottic larynx observed from 1969 to 1993 in t he ORL Clinic of the University of Florence. This number constitutes 1.6% o f all laryngeal cancers observed during this period. Four (8.2%) patients w ere stage T1, 13 (26.5%) T2, 27 (55.1%) T3, and 5 (10.2%) T4. Forty-one pat ients were eligible for assessing the disease-free five-year survival rate, 17 of whom were treated with surgery alone, 6 with radiotherapy alone and 18 with combination therapy (surgery for the primary tumor and post-operati ve radiotherapy for cervical nodes). The five-year survival rate for the th ree treatment types was 47%, 0% and 83.3%, respectively. The overall surviv al rate was 56.1%. Combination therapy produced a significantly higher (P = 0.001) disease-free survival than surgery alone or radiotherapy alone.