Conservative Surgical and Non-surgical Options in Management of T3 Laryngeal Cancer

Abstract

Purpose of Review

We herein address the most up-to-date findings in the literature in relation to surgical and non-surgical organ preservation strategies aimed at treatment of T3 laryngeal cancer.

Recent Findings

T3 laryngeal cancer represents an advanced stage of neoplastic lesions that poses significant challenges in terms of oncologic outcomes as well as function preservation. In the present form of the TNM staging system, T3 of the larynx includes a wide range of different neoplasms that spread into the visceral (paraglottic and pre-epiglottic) spaces of the organ or tend to infiltrate its cartilaginous framework. A number of therapeutic tools are available for its management and include transoral laser microsurgery, open-neck partial laryngectomies, non-surgical organ preservation strategies (mainly in the form of concurrent chemoradiation), and total laryngectomy with/without complementary (chemo)-radiotherapy according to the postoperative histopathologic evaluation of the surgical specimen.

Summary

No prospective randomized controlled trial has been performed to compare the different options in terms of oncologic and functional outcomes due to the multiple tumor and patient-related variables that should ideally be taken into account. Therefore, lacking precise evidence-based data, the choice among the different therapeutic alternatives, even in the presence of a multidisciplinary head and neck cancer team, is mainly made on the basis of institutional and cultural preferences.

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