Management of cancer of the supraglottis

We present the results of a retrospective study of 903 patients treated wit h conservation surgery for carcinoma of the supraglottic larynx so we can e valuate our management of supraglottic cancer with different types of surge ry. In 301 patients, an extended supraglottic laryngectomy was performed. T he recent selective use of transoral laser resection appears to be a ration al approach. The 5-year uncorrected survival was 84%, 81%, 76%, and 55% for stages I, II, III, and IV, respectively. The most common site for local-re gional failure was the cervical lymphatics. The percentage of occult diseas e in the NO neck was 21% and epilaryngeal supraglottic location, locally ad vanced and GIII tumors have a higher frequency of lymph node involvement. T here were no differences between comprehensive and anterolateral elective n eck dissections. A bilateral elective neck dissection is recommended. In hi stologically positive neck disease, the survival rates were better with pos toperative radiotherapy only in cases of extracapsular spread.