Supraglottic carcinoma: A retrospective study of 114 patients

We retrospectively evaluated the management of supraglottic carcinoma at our centre during the last 35 years to determine the preferred mode of treatment. A review of the medical records yielded 114 patients with supraglottic T-1 and T-2 carcinoma who were diagnosed and treated in the Departments of Otolaryngology, Head and Neck Surgery, and Oncology between 1959 and 1993. Of these, 47 (41.2%) had T-1 carcinoma (stage I) and 67 (58.8%) T-2 (stage II). Treatment varied among radiotherapy, surgery, or combined radiotherapy acid surgery. Twelve patients under,vent elective neck dissection, one of whom (8.3%) was found to have occult metastases. Local failures were noted in 22 patients (11 T-1: 11 T-2), three of whom also had neck metastases. All except one T-2 patient received radiotherapy. Radiotherapy yielded the best survival rates for T-1 disease as combined therapy did for T-2. Five-year recurrence rates for T-1 patients were 35% for those treated by radiotherapy and 42% for those treated with combined therapy; corresponding figures for T-2 patients were 39% and 28%. We suggest that patients with T-1 supraglottic carcinoma be managed with radiotherapy and patients with T-2 with combined therapy. We believe there is no need for elective neck dissection, especially in T-1.