We retrospectively evaluated the management of supraglottic carcinoma
at our centre during the last 35 years to determine the preferred mode
of treatment. A review of the medical records yielded 114 patients wi
th supraglottic T-1 and T-2 carcinoma who were diagnosed and treated i
n the Departments of Otolaryngology, Head and Neck Surgery, and Oncolo
gy between 1959 and 1993. Of these, 47 (41.2%) had T-1 carcinoma (stag
e I) and 67 (58.8%) T-2 (stage II). Treatment varied among radiotherap
y, surgery, or combined radiotherapy acid surgery. Twelve patients und
er,vent elective neck dissection, one of whom (8.3%) was found to have
occult metastases. Local failures were noted in 22 patients (11 T-1:
11 T-2), three of whom also had neck metastases. All except one T-2 pa
tient received radiotherapy. Radiotherapy yielded the best survival ra
tes for T-1 disease as combined therapy did for T-2. Five-year recurre
nce rates for T-1 patients were 35% for those treated by radiotherapy
and 42% for those treated with combined therapy; corresponding figures
for T-2 patients were 39% and 28%. We suggest that patients with T-1
supraglottic carcinoma be managed with radiotherapy and patients with
T-2 with combined therapy. We believe there is no need for elective ne
ck dissection, especially in T-1.