Transoral surgery in early-stage laryngeal cancer

Single modality treatment is advocated for early laryngeal cancer, providing superior functional outcome and crucially options for further treatment in the event of local tumor recurrence. Options include surgery (mainly in the form of endolaryngeal techniques) or radiotherapy. With no prospective direct randomized controlled trials available, the choice of treatment following multidisciplinary discussion rests on a combination of tumor, patient and local expertise factors, with ultimately patient choice taking precedence. However, recently published data support the case for primary surgery on the basis of both organ preservation and health economics in early laryngeal cancer. We present an evidence-based review of the current literature in the management of primary and recurrent early laryngeal cancer