A 58-year-old male with T2N1M0 squamous cell carcinoma of the glottis (right true vocal cord with subglottic extension, right level II lymph node 2.5 cm) is planned for definitive treatment. Which is the MOST appropriate management?
- A Concurrent chemoradiation (cisplatin-based) as organ preservation strategy ✓
- B Total laryngectomy with right neck dissection
- C Partial laryngectomy (vertical hemilaryngectomy) alone
- D Radiation alone without chemotherapy
Correct answer: A. Concurrent chemoradiation (cisplatin-based) as organ preservation strategy
Explanation
T2N1 glottic carcinoma is an intermediate stage where organ preservation via concurrent chemoradiation (RTOG 91-11 protocol with cisplatin) is the standard of care, offering larynx preservation rates comparable to surgery. Total laryngectomy is reserved for failed chemoradiation or T3/T4 disease. Partial laryngectomy alone does not adequately address neck disease. Radiation alone is inferior to chemoradiation for N1 disease.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.