Principles of selecting treatment for Supraglottic 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