الفهرس 
Treatment of Advanced Cancer LarynxOnly 14 pages are availabe for public view
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Abstract
Laryngeal cancer accounts for 2 – 5 % of all cancers, the incidence being higher among males than females. Smoking and alcohol represent the major behavioral risk factors. (Licitra et al., 2003)
The laryngeal tumors are classified generally to epithelial, mesenchymal and hematopiotic. (Kaznelson and Schindel, 1979)
The epithelial tumors are clearly the most common form of laryngeal malignancy. (Ferlito et al., 1996)
The vast majority of laryngeal cancers are of squamous cell histology. Squamous cell subtypes include keratinizing and nonkeratinizing and well-differentiated to poorly-differentiated grade. (Sessions et al., 2001)
For most patients, a total laryngectomy should not be used as the initial treatment for any stage laryngeal tumor. The goal in treating a patient with laryngeal cancer must be not only to cure but also to provide the best functional outcome for the patient. (Laramore and Coltrea, 2003)
Organ preservation strategies include definitive radiation therapy alone, induction chemotherapy followed by radiotherapy, and concurrent chemo-radiotherapy. Surgery is used for management of the neck and as salvage therapy for disease at the primary site that is unresponsive to chemotherapy and radiotherapy. (Gilbert and Forastiere. 2002)
Organ preservation surgery for laryngeal cancer is an art. The art is in determining which patients are eligible for an organ preservation surgical procedure. One must delicately balance the need for maximizing local control with a good functional outcome. All patients with laryngeal cancer should be evaluated for organ preservation surgery from their initial visit. It is the head and neck surgeon’s role to find a reason why the patient would not be eligible for an organ preservation surgical approach. Certain key principles must be systematically adhered to in determining patient eligibility. (Weinstein et al., 2000)