Carcinoma of the supraglottic larynx: treatment results with radiotherapy alone or with planned neck dissection.
OBJECTIVE
To present the results of radiotherapy with or without neck dissection for squamous cell carcinoma of the supraglottic larynx treated at the University of Florida and to compare these data with those obtained after conservation surgery.


METHODS
Continuous-course radiotherapy alone or combined with a planned neck dissection was used to treat 274 patients with squamous cell carcinoma of the supraglottic larynx between 1964 and 1998. All patients had follow-up for a minimum of 2 years, and 250 (91%) had follow-up for 5 years or more.


RESULTS
At 5 years, the actuarial probability of local control after radiotherapy according to T stage was as follows: T1, 100%; T2, 86%; T3, 62%; and T4, 62%. The probability of cause-specific survival at 5 years by AJCC stage was as follows: stage I, 100%; II, 93%; III, 81% IVA, 50%; and IVB, 13%. The risk of severe late complications was 4%. Of 57 patients undergoing planned postradiotherapy neck dissection, 7% experienced a severe complication.


CONCLUSIONS
On the basis of our data and the literature, early or moderately advanced supraglottic carcinomas may be treated successfully with either supraglottic laryngectomy or radiotherapy. Supraglottic laryngectomy probably produces a higher initial local control rate but, based on anatomic and coexisting medical constraints, is suitable for a smaller subset of patients and has a higher risk of complications compared with radiotherapy.
Hinerman
Russell W
RW
Department of Radiation Oncology, University of Florida Health Science Center, 2000 SW Archer Road, PO Box 100385, Gainesville 32610-0385, USA. hinerrw@shands.ufl.edu
Mendenhall
William M
WM
Amdur
Robert J
RJ
Stringer
Scott P
SP
Villaret
Douglas B
DB
Robbins
K Thomas
KT
D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005931:Glottis; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D009367:Neoplasm Staging; D016896:Treatment Outcome