To the Editor.—The article entitled "Management of Early Supraglottic Laryngeal Carcinoma by Irradiation With Surgery in Reserve" by Harwood et al,1 published in the September 1983 Archives, requires comment. In this article, Harwood et al suggest that radiation for cure and laryngectomy for salvage is the treatment of choice for supraglottic cancer. I certainly do not agree. This approach is an option but not the only option.
What Harwood has done is to take a selected group of supraglottic cancers (T1, T2, NO) and compared the adjusted survival statistics treated in this protocol with surgical data collected and published by others, including Coates et al2 and the St Louis experience. Harwood's statistics are selected in two ways: (1) the patients who had cervical nodes have been eliminated from this study, and (2) patients who in the beginning did not do well with radiation were excluded from this
DESANTO LW. Radiation in the Treatment of Early Supraglottic Cancer. Arch Otolaryngol. 1984;110(3):208. doi:10.1001/archotol.1984.00800290072017
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