Endoscopic treatment for early glottic cancer: Indications and oncologic outcome

The authors' treatment approach for the comprehensive management of early glottic cancer can be divided into two basic therapeutic scenarios. Tis and T1a lesions of the midcord are treated preferably by an excisional biopsy, which, after appropriate pre- and intracoperative diagnostic work-up, allows precise diagnosis and definitive treatment of these lesions. This approach is associated with minimal morbidity, short hospitalization time, and a high cost-effectiveness ratio. Moreover, the postoperative voice has been shown to be comparable to that of controls because most of the vocalis muscle is preserved. On the other hand, T1b and T2 tumors deserve special attention because comparable oncologic outcomes may be seen with other therapeutic modalities. Therefore, appropriate preoperative counseling, including other voice-sparing options (eg, radiation or chemoradiation therapy) should always be part of the informed consent discussion.