A professional voice user has a small T1a glottic squamous-cell carcinoma confined to one vocal fold with normal mobility. What is the best decision principle?
Both modalities can provide high local control in selected early glottic cancer. Choice should consider tumour exposure, anterior-commissure involvement, voice needs, treatment burden, salvage options and patient preference.
A. Total laryngectomy: This is disproportionate for a small mobile T1a lesion.
B. Chemoradiotherapy: Concurrent chemotherapy is not routinely required for a localised T1a glottic cancer.
C. Observation because mobility is normal: Normal mobility defines early stage but does not make invasive carcinoma safe to observe.
D. Laser treatment without discussing radiotherapy: Valid consent requires balanced discussion of reasonable alternatives and functional implications.
E. Discuss transoral laser microsurgery and radiotherapy as curative options with functional trade-offs: Both modalities can provide high local control in selected early glottic cancer. Choice should consider tumour exposure, anterior-commissure involvement, voice needs, treatment burden, salvage options and patient preference.
If the tumour impaired vocal-fold mobility or extended deeply, staging and treatment options would need escalation beyond the T1a framework.
Independent Clinora educational preparation material; not official JCIE content, an accredited programme, clinical advice, or a substitute for local policy and specialist judgement.
Back to the Section 1 bank