Glottic Cancer Guidelines

Updated: Dec 03, 2021
  • Author: Andrew M Coughlin, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Guidelines Summary

Appropriateness Criteria® for the treatment of stage I T1 glottic cancer, issued by the American College of Radiology (ACR) in 2012, includes the following recommendations [21] :

  • Surgical treatment: For patients with T1a disease visible in its entirety on direct laryngoscopy and an intact mucosal wave, transoral endolaryngeal resection is recommended 
  • Radiation treatment: For patients with disease not treatable with transoral laryngeal resection, radiation therapy is the preferred first-line treatment; open partial laryngectomy is an alternative, although vocal quality may be better with radiation therapy
  • Recurrent disease: Most patients remain candidates for additional treatment, with the best therapy dependent on the initial treatment strategy; while larynx preservation remains achievable, patients should be counseled regarding the potential requirement for total laryngectomy
  • The treatment of choice for many patients will depend on patient-specific factors, including proximity to treatment centers

The 2012 Cancer Care Ontario guidelines state that endolaryngeal surgery, with or without laser, and radiation therapy are equally effective for patients with early (T1) glottic cancer and recommend that patient and clinician preferences and general medical condition drive the choice of treatment. [22]