title: Management and pitfalls of stage I/II glottic cancer.
abstract: CONCLUSIONS
  Once-daily radiotherapy for stage I glottic cancer and hyperfractionated radiotherapy for stage II glottic cancer achieved satisfactory results in terms of prognosis and laryngeal preservation. The treatment strategy for stage II glottal cancer with subglottal invasion needs to be reconsidered to further improve the outcome.
  
  
  OBJECTIVE
  Although early glottic carcinomas are highly curable by radiation therapy, the laryngeal preservation rate is not always sufficient. We reviewed the stage I/II glottal cancer treated in our institute during a recent 15-year period to improve the outcome and prognosis.
  
  
  METHODS
  In all, 113 cases of stage I/II glottic cancer (81 stage I cases and 32 stage II cases) were treated in Kyoto University hospital from 1994 to 2008. In 81 cases with stage I glottic cancer, radiation was performed for 66 cases, transoral laser excision (TLE) was performed for 14 cases, and hyperfractionated radiotherapy was done for one case. Among 32 cases with stage II glottic cancer, 24 cases were treated with hyperfractionated radiotherapy, 6 cases were treated with radiation, and one case with partial laryngectomy. Total laryngectomy was performed for one patient who suffered mixed connective tissue disease. Kaplan-Meier estimates were used for the analysis of survival rate and laryngeal preservation rate.
  
  
  RESULTS
  The 5-year overall survival rates were 88.4% in stage I cases and 89.1% in stage II cases. The 5-year disease-specific survival rates were 100% in stage I cases and 93% in stage II cases. The 5-year laryngeal preservation rates were 99% in stage I cases and 90% in stage II cases. Two cases of stage II glottal cancer with subglottal invasion failed to be controlled and the patients died from local recurrence and mediastinum lymph node metastasis, respectively.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Kyoto University Hospital, Kyoto, Japan. tateya@ent.kuhp.kyoto-u.ac.jp
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tateya
authors.forename: Shigeru
authors.initials: S
authors.lastname: Hirano
authors.forename: Morimasa
authors.initials: M
authors.lastname: Kitamura
authors.forename: Shinpei
authors.initials: S
authors.lastname: Kada
authors.forename: Seiji
authors.initials: S
authors.lastname: Ishikawa
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kanda
authors.forename: Ryo
authors.initials: R
authors.lastname: Asato
authors.forename: Shinzo
authors.initials: S
authors.lastname: Tanaka
authors.forename: Juichi
authors.initials: J
authors.lastname: Ito
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005931:Glottis; D006801:Humans; D007564:Japan; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome