Treatment of Carcinoma Larynx
Treatment depends on:
- tumour site
- stage
- nodal status
- patient fitness
Goals:
- cure
- preserve airway
- preserve voice
Treatment Modalities
- Radiotherapy
- Surgery
- Chemotherapy
- Combined treatment
Early Glottic Cancer
Usually treated with:
- radiotherapy or
- conservative laryngeal surgery
Voice preservation is possible.
Supraglottic Carcinoma
Early Disease
- radiotherapy
- partial laryngectomy
Advanced Disease
- total laryngectomy
- neck dissection
- postoperative radiotherapy
Subglottic Carcinoma
Often requires:
- total laryngectomy
- radiotherapy
- neck dissection
Total Laryngectomy
Entire larynx is removed.
Indications
- advanced disease
- cartilage invasion
- recurrent tumour
Consequences
- permanent tracheostomy
- loss of natural voice
Prognostic Factors
Poor prognosis associated with:
- cord fixation
- cartilage invasion
- nodal metastasis
- delayed diagnosis