In a patient with T1a glottic carcinoma (confined to one vocal cord with normal mobility), the preferred primary treatment option in a specialized center that offers equivalent oncological outcomes to radiotherapy while providing an immediate histological specimen is:

• A Open cordectomy via laryngofissure
• B Hemilaryngectomy
• C Total laryngectomy with reconstruction
• D Transoral laser microsurgery (TLM) cordectomy ✓

Explanation

For T1a glottic carcinoma, both radiotherapy and transoral laser microsurgery (TLM) provide equivalent local control rates of 85–95%. TLM (using CO2 laser under microlaryngoscopy) is preferred in specialized centers because it provides immediate histopathological confirmation of margins, avoids radiation effects, preserves voice quality comparable to radiotherapy, has shorter treatment duration, and allows re-treatment. Open cordectomy via laryngofissure (external approach) is reserved when TLM is not feasible. Hemilaryngectomy is for T2 lesions. The European Laryngological Society cordectomy classification (Types I–V) guides the extent of TLM resection.

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.