A 52-year-old male smoker presents with a T2N1M0 squamous cell carcinoma of the glottis. The ipsilateral level II lymph node measures 2.8 cm and is clinically palpable. The standard treatment of choice is:
- A Total laryngectomy with ipsilateral selective neck dissection (levels II–IV)
- B Supraglottic laryngectomy with bilateral neck dissection
- C Concurrent chemoradiotherapy as organ-preservation protocol ✓
- D Radiotherapy alone with monthly neck palpation
Correct answer: C. Concurrent chemoradiotherapy as organ-preservation protocol
Explanation
For T2N1 glottic SCC, the Veteran Affairs Laryngeal Cancer Study and RTOG 91-11 established concurrent chemoradiotherapy (cisplatin-based) as the preferred organ-preservation approach with equivalent survival to total laryngectomy. Total laryngectomy is reserved for failed organ preservation or bulky T4 disease. Supraglottic laryngectomy is inappropriate for glottic tumors. Radiotherapy alone provides inferior locoregional control in node-positive 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.