Key Points
➤ Patients with T1, T2 laryngeal cancer should be treated initially with intent to
preserve the larynx using endoscopic resection or radiation therapy, with either
leading to similar outcomes.
➤ For patients with locally advanced (T3, selected T4 or low volume T4) disease,
organ-preservation surgery, combined chemotherapy and radiation, or radiation
alone, offers the potential for larynx preservation without compromising overall
survival.
➤ For selected patients with extensive T3 or large T4a lesions and/or poor
pretreatment laryngeal function, better survival rates and quality of life may
be achieved with total laryngectomy.
➤ Patients with clinically involved regional cervical nodes (N+) who have a
complete clinical and radiologic imaging response after chemoradiation
do not require elective neck dissection.
➤ All patients should undergo a pretreatment, baseline assessment of voice
and swallowing function and receive counseling regarding potential impact of
treatment options on voice, swallowing, and quality of life.
