Principles of selecting treatment for Glottic Cancer

  • Should require a lot of thought
  • Need to individualise treatment
  • Cannot simply base on TNM staging
  • Need to balance cure with preservation of function
    • Swallowing
    • Voice
    • Aspiration
    • Airway
  • Consider patient’s values, beliefs, financial status, socioeconomic support
  • Consider available resources
  • Tumour factors
    • Site
    • Stage
    • Cartilage invasion
    • Ability to spare the arytenoid complex
  • Prior therapy
    • Radiation
    • Partial laryngectomy
  • Patient factors
    • Age, fitness, pulmonary status (tolerate aspiration)
    • Cognitive status
    • Values and beliefs
    • Socioeconomic status and social support
    • Access to thyroid replacement therapy
    • Reliability for follow-up
  • Institutional support
    • Surgical expertise
    • Availability of CO2 laser transoral microsurgery
    • Radiotherapy package of care
    • Speech and swallowing support
    • Tracheo-oesophageal speaking valves/ electrolarynx

Index: Clinical Practice Guidelines for Glottic Cancer

Resource Appropriate Glottic Cancer Guideline Scenarios