A 60-year-old chronic smoker presents with hoarseness of 8 months duration. Laryngoscopy shows a growth limited to the right vocal cord with normal cord mobility. There is no palpable neck lymphadenopathy. CT staging confirms T1N0M0 glottic carcinoma. What is the most appropriate treatment?

• A Radiotherapy alone with curative intent ✓
• B Total laryngectomy with bilateral neck dissection
• C Chemotherapy with cisplatin
• D Endoscopic CO2 laser cordectomy followed by adjuvant chemotherapy

Explanation

T1N0M0 glottic carcinoma has an excellent cure rate (>90%) with radiotherapy alone, which also preserves excellent voice quality. Endoscopic CO2 laser cordectomy is an equally valid alternative for early glottic cancer. Total laryngectomy is reserved for recurrence or advanced disease. Glottic cancer has low lymphatic drainage density, explaining the rarity of nodal metastases at early stages. Radiotherapy alone is preferred when voice preservation with best functional outcome is the goal.

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.