The prognosis of early stage laryngeal carcinoma treated with radiation therapy or
surgery (preferably transoral resection) is favorable. In these cases, the choice
of the therapy is mainly driven by functional outcomes (speech, swallowing and respiratory
function). However, there has not been any substantial improvement in the treatment
of locoregionally advanced larynx cancer. The selection of the most ideal therapy
is difficult, as upfront total laryngectomy is rather radical, and has a dramatic
effect on quality of life, whereas reliable predictors of radiosensitivity are lacking.
Moreover, current data undermines the oncologic effectiveness of salvage laryngectomy.
In this review, we summarize the current anatomical and functional facts and concepts
with respect to the previous clinical trials and studies that might influence the
decision making during the treatment of a laryngeal cancer patient in 2025.