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Treatment of laryngeal carcinoma
Author(s) -
Kramer Rudolph
Publication year - 1938
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1288/00005537-193809000-00003
Subject(s) - medicine , larynx , surgery , carcinoma , cancer , general surgery
This study of carcinoma of the larynx is an attempt to analyze for myself the results of treatment and to determine, if possible, any indications for the selection of the type of treatment most likely to be successful in any particular case. It is true that the number of cases in this series is relatively small and in some instances the time elapsed after treatment has been too short for clear‐cut conclusions. Nevertheless, some of the patients have been observed sufficiently long to evaluate the results of treatment. I am of the opinion that the general viewpoint of time elapsed after treatment of laryngeal cancer in relationship to cure is of little help in studying the results. The usual periods selected are three or five years after therapy. As a matter of fact, most recurrences, local or glandular, take place in much less than one year. In this series of cancer cases there has been no local or glandular recurrence after the first year, with one exception, which occurred 12 years postoperative. I do not for a moment deny that recurrences or metastases take place two, three or five years after operation, but they are comparatively infrequent. I am of the opinion that if patients are observed routinely by follow‐up every two or four weeks, as I do with all my patients, recurrences will be noted early; long before they fall into the two‐ or three‐year recurrence group. On the other hand, the three‐ or five‐year period is much too short because patients do occasionally get late local or distant metastases seven, 10 or 20 years after treatment. Therefore, reliable definitive statistics on the treatment of laryngeal carcinoma can only be obtained after many years of observation, a longer period of time than any one man is likely to cover in his active medical years. There are exceptions, such as Chevalier Jackson and St. Clair Thomson, who are able to report lengthy follow‐ups on their thyrotomy cases. It will require relays of laryngologists following the courses of therapeutic procedures for many years to estimate the value of each procedure if in the meantime the specific etiology and treatment of cancer are not discovered. For we must remember that we have not been treating carcinoma itself, but a local manifestation of a general disease or tendency. In the interim tentative reports such as this are in order so that a mass of material may be available for the study of various procedures and their indications in the treatment of laryngeal cancer.