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Clinical Challenges
September 2005

Selecting From the Menu of Treatment Options for Locally Advanced Laryngeal Cancer

Author Affiliations




Arch Otolaryngol Head Neck Surg. 2005;131(9):819. doi:10.1001/archotol.131.9.819

Enepekides provides an excellent overall perspective of treatment options for T3 laryngeal carcinomas. He correctly concludes that patients now have a choice among several options, many of which offer the hope of preserving laryngeal function. Of greatest significance highlighted in this review is the progress made over the past decade in the treatment of advanced laryngeal cancer. Whereas most patients previously were offered a TL with its inherent loss of function, in today’s world, this is not the case. Enepekides provides a well-balanced review of the treatment spectrum, ranging from conservation surgery to various types of CRT. Also implied by this review is the inherent preference that exists among oncologists for certain treatment approaches, and such preferences tend to be country and institution related. Much of the credit for the treatment advances in laryngeal cancer should go to our colleagues in radiation and medical oncology and to head and neck surgeons in other countries. In particular, our German colleagues have been prominent in developing transoral laser microsurgery and its applicability for selected T3 and even T4 laryngeal cancers. Of equal significance, our French colleagues have pushed the envelope of the open conservation laryngeal approach that now incorporates the removal of both vocal cords in addition to the supraglottic structures.