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 T₁ and T₂ carcinoma who mere diagnosed and treated in the Departments of Otolaryngology, Head and Neck Surgery, and Oncology between 1959 and 1993. Of these, 47 (41.2%) had T₁ carcinoma (stage I) and 67 (58.8%) T₂ (stage II). Treatment varied among radiotherapy, surgery, or combined radiotherapy and surgery. Twelve patients underwent elective neck dissection, one of whom (8.3%) was found to have occult metastases. Local failures were noted in 22 patients (11 T₁: 11 T₂), three of whom also had neck metastases. All except one T₂ patient received radiotherapy. Radiotherapy yielded the best survival rates for T₁ disease as combined therapy did for T₂. Five-year recurrence rates for T₁ patients were 35% for those treated by radiotherapy and 42% for chose treated with combined therapy; corresponding figures for T₂ patients were 39% and 28%. We suggest that patients with T₁ supraglottic carcinoma be managed with radiotherapy and patients with T₂ with combined therapy. We believe there is no need for elective neck dissection, especially in T₁.