Foreword

Article Outline

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For years, total laryngectomy remained the only option for patients with intermediate to advanced stage disease. But in the last 15 years, striking improvements in the treatment for laryngeal cancer have been made. In 1991, the landmark study published by the Veterans Affairs Laryngeal Cancer Study Group provided the first evidence for nonsurgical organ preservation. In 2003, the RTOG 91-11 study validated this approach and provided convincing evidence that chemoradiation was the most effective regimen for non-surgical laryngeal organ preservation.

While many patients with intermediate to advanced staged disease now receive a non-surgical treatment approach, questions remain about the functional outcome for these patients. Some might effectively treated by either partial laryngectomy or other modalities. Refinement in techniques of partial laryngeal surgery now offers patients a serviceable voice without a permanent stoma. The clinician and patient are now confronted with a panoply of options for treatment of laryngeal cancer, and decisions are often based upon the treating physician’s and the patient’s preference.

In this issue of Current Problems in Cancer, the contributing authors provide an overview of the surgical techniques and therapeutic modalities available for patient with early to late stage laryngeal cancer. The application of open partial laryngeal surgery, endoscopic laser surgery, and the supracricoid laryngectomy are described from the perspective of indications, technique, and their role in the therapeutic armamentarium. Survival remains the most important priority; however, therapeutic decisions should also be tailored to the individual patient based upon the presence of co-morbid conditions, tumor extent and achieving optimal functional outcome. Ultimately the best therapeutic regimen for patients with laryngeal cancer is developed and delivered through participation and input from a multidisciplinary treatment team where each discipline provides critical input to achieve these goals.