[The treatment of the "mobile" vocal cord carcinoma: cordectomy versus irradiation (author's transl)].
In the literature, cordectomy and irradiation each give an about 80% 5-year cure rate in cases of stage I carcinoma of the vocal cords. Between 1955 and 1969 49 patients were cordectomized and 71 patients were subjected to irradiation (5-year absence of recurrence in 75%) and 68.8% of cases respectively. 6 out of 9 criteria are in favour of cordectomy and only 3 in favour of radiotherapy in a comparison of both forms of treatment. In favour of cordectomy: 1. Direct examination of the tumour. 2. Immediate histological control during the operation. 3. Duration of treatment: 7 to 10 days (irradiation: 4 to 5 weeks). 4. Short healing period. Irradiation may entail chronic after effects. 5. Perichondritis: not observed after operation but may follow irradiation. 6. Treatment of tumour recurrence: After cordectomy: non-irradiated area and, if required, full radiation dose possible or operation in ordinary tissue. After irradiation: full radiation dose not possible, operation only in irradiated tissue. In favour or irradiation: 1. Medical contra-indications to surgery. 2. Tracheotomy: required prophylactically in case of cordectomy for 1 to 3 days, usually not necessary in case of irradiation. 3. Voice quality: Clearly better after irradiation than after operation. Irradiation is preferable in patients who have to use their voice very much. The problem should be thoroughly discussed with the patient. In general, cordectomy is the treatment of choice.
D004564:Electrocoagulation; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011879:Radiotherapy Dosage; D013064:Speech Disorders; D014140:Tracheotomy; D014827:Vocal Cords / Q000601:surgery*; D014831:Voice
Zur Behandlung des "beweglichen" Stimmbandkarzinoms: Chordektomie, Bestrahlung