In the management of early glottic carcinoma (T1N0M0), which statement best reflects current evidence-based guidelines regarding oncologic outcomes of radiotherapy versus laser cordectomy?
- A Total laryngectomy is preferred for T1 glottic lesions to ensure cure
- B Radiotherapy and transoral laser microsurgery (TLM) have equivalent local control rates of approximately 85–95%, with voice quality better after laser for T1a ✓
- C Radiotherapy is always superior to laser surgery in terms of local control
- D Chemotherapy plus radiotherapy is the standard for T1N0 glottic cancer
Correct answer: B. Radiotherapy and transoral laser microsurgery (TLM) have equivalent local control rates of approximately 85–95%, with voice quality better after laser for T1a
Explanation
For T1N0 glottic carcinoma, both external beam radiotherapy and transoral laser microsurgery (TLM) achieve comparable local control rates (~85–95%). Voice quality outcomes are generally equivalent, though some studies favor TLM for T1a lesions due to better mucosal wave preservation. Radiotherapy has the advantage of treating the entire cord but requires multiple daily fractions. TLM offers single-session treatment with organ preservation. Total laryngectomy is not indicated for T1 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.