title: Role of endolaryngeal surgery (with or without laser) compared with radiotherapy in the management of early (T1) glottic cancer: a clinical practice guideline.
abstract: OBJECTIVE
  To provide evidence-based practice guideline recommendations concerning the role of endolaryngeal surgery (with or without laser) compared with radiation therapy for patients with early (T1) glottic cancer, assessing survival, locoregional control, laryngeal preservation rates, and voice outcomes.
  
  
  METHODS
  The medline, embase, and Cochrane Library databases were searched to identify relevant studies from 1996 to 2011. Recommendations were formulated based on that evidence and on the expert opinion of Cancer Care Ontario's Head and Neck Cancer disease site group. The systematic review and practice guideline were externally reviewed by practitioners in Ontario, Canada.
  
  
  RESULTS
  The available evidence was of a level insufficient to demonstrate a clear difference between treatment options when considering the likelihood of local control or overall survival. Although the evidence was mainly retrospective, there was a suggestion that, compared with surgery, radiotherapy might be associated with less measureable perturbation of voice without a significant difference in patient perception. The likelihood of laryngeal preservation may be higher when surgery can be offered as initial treatment.
  
  
  CONCLUSIONS
  For patients with early (T1) glottic cancer, the evidence is insufficient to demonstrate a difference between endolaryngeal surgery (with or without laser) and external-beam radiation therapy. The choice between treatment modalities has been based on patient and clinician preferences and general medical condition.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON.
authors.forename: J
authors.initials: J
authors.lastname: Yoo
authors.forename: C
authors.initials: C
authors.lastname: Lacchetti
authors.forename: J A
authors.initials: JA
authors.lastname: Hammond
authors.forename: R W
authors.initials: RW
authors.lastname: Gilbert
keywords: Endolaryngeal; T1; glottic; radiotherapy; surgery
references.citation: J Otolaryngol Head Neck Surg. 2011 Jun;40(3):200-4
references.pmid: 21518640
references.citation: Head Neck. 2001 Oct;23(10):823-9
references.pmid: 11592228
references.citation: J Otolaryngol Head Neck Surg. 2011 Jun;40(3):205-10
references.pmid: 21518641
references.citation: J Otolaryngol Head Neck Surg. 2011 Feb;40 Suppl 1:S49-58
references.pmid: 21453662
references.citation: Ann Otol Rhinol Laryngol. 2001 Apr;110(4):312-8
references.pmid: 11307905
references.citation: Head Neck. 1997 Dec;19(8):692-700
references.pmid: 9406748
references.citation: Radiother Oncol. 1998 Aug;48(2):175-83
references.pmid: 9783889
references.citation: Arch Otolaryngol Head Neck Surg. 2009 Apr;135(4):363-8
references.pmid: 19380358
references.citation: Laryngoscope. 2003 Jan;113(1):68-76
references.pmid: 12514385
references.citation: Eur Arch Otorhinolaryngol. 2004 Nov;261(10):534-40
references.pmid: 14714128
references.citation: Eur Arch Otorhinolaryngol. 2010 May;267(5):743-50
references.pmid: 19898826
references.citation: Head Neck. 2003 Dec;25(12):1051-6
references.pmid: 14648864
references.citation: Strahlenther Onkol. 2010 Nov;186(11):607-13
references.pmid: 21069268
references.citation: J Clin Oncol. 1995 Feb;13(2):502-12
references.pmid: 7844612
references.citation: Head Neck. 2008 Sep;30(9):1167-74
references.pmid: 18528901
references.citation: Cancer. 2004 May 1;100(9):1786-92
references.pmid: 15112257
references.citation: J Otolaryngol Head Neck Surg. 2009 Dec;38(6):603-12
references.pmid: 19958721
references.citation: Head Neck. 2009 Jun;31(6):759-64
references.pmid: 19260127
references.citation: Eur J Surg Oncol. 2008 Jun;34(6):692-8
references.pmid: 17686606