Key Points LARYNGEAL CANCER THERAPY Early-Stage Glottic Cancer and Supraglottic Cancer (T1-T2 Lesions) Treatment options include either radiation therapy (RT) or surgery (e.g., “stripping,” laser excision for glottic cancers). Definitive RT offers several advantages over a primary surgical option, such…
Key Points Total laryngectomy remains the standard by which other forms of treatment for advanced primary laryngeal carcinoma are evaluated. It should still be considered as a primary treatment modality for selected patients. Total laryngectomy is also occasionally indicated for…
Key Points Four principles of organ-preservation surgery help provide consistent oncologic and functional outcomes: local control, accurate assessment of the three-dimensional extent of tumor, the cricoarytenoid unit as the basic functional unit of the larynx, and resection of normal tissue…
Key Points Transoral laser microsurgery (TLM) permits both small and large laryngeal tumors to be resected. The limits of resectability are based on access and functional consequences and not on extent or T stage. Piecemeal resection of cancer permits precise…
Key Points Early glottic cancer commonly presents as dysphonia associated with a white or red lesion of the vocal cord. Laryngeal leukoplakia is defined as a white lesion of mucosa that, based on its clinical features, cannot be assigned a…
Key Points Squamous cell carcinoma (SCC) accounts for 85% to 95% of malignant laryngeal tumors. Tobacco and alcohol are the two most important risk factors for the development of laryngeal SCC. In the United States, laryngeal SCC occurs in the…
Key Points Computed tomography (CT) and magnetic resonance (MR) imaging have become the procedures of choice for defining mass lesions and traumatic abnormalities. They supplement the findings at laryngoscopy when additional diagnostic information is required to plan treatment. Appreciation of…
Key Points To obtain the best outcome for the patient, perform pharyngoesophageal reconstruction as part of a knowledgeable multidisciplinary team. Hypopharyngeal defects are associated with the highest surgical complication rates in the head and neck. Careful monitoring of thyroid-stimulating hormone…
Key Points Advanced hypopharyngeal cancer is treated in a multimodality approach, either surgery followed by radiation with or without chemotherapy or with definitive chemoradiation. Induction larynx-preserving strategies should incorporate assessment of response to induction (bioselection). Postoperative chemoradiation with cisplatin is…
Key Points Patients with hypopharyngeal carcinoma have the worst prognosis when compared with other subsites of head and neck cancer. Hypopharyngeal carcinoma tends to have significant submucosal extent that can be hard to appreciate clinically and radiographically. Organ-preservation therapy for…