Management of stage I laryngeal carcinoma is -
Ans. is 'c' i.e., Radiotherapy TNM classification of cancer larynx (American Joint Committee on Cancer, 2002SupraglottisT1Tumour limited to one subsite of supraglottis with normal vocal cord mobility.T2Tumour invades mucosa of more then one adjauent subsite of supraglotis or glottis or region outside the supraglottis (e.g., mucosa of base of tongue, vallecula, medial wall of pyriform sinus) without fixation of the larynxT3Tumour limited to laynx with vocal cord fixation and or invades any of the following postcricoid area, pre- epiglottic tissues, paraglottic space and or minor thyroid cartilage invasionT4Tumour invades through the thyroid cartilage and or invades tissues beyond the larynx (e.g., trachea, soft tissues of neck including deep extrinsic muscle of tongue, strap muscles, thyroid or oesophagus)T5Tumour invades prevertebral space, encases carotid artery or invades mediastinal structuresGlottisT1Tumour limited to vocal cord(s) (may involve anterior or posterior commissures) with normal mobilityT2Tumour limited to one vocal cordT3Tumour involves both vocal cordsT4Tumour extends to suproglottis and or subglottis and or with impaired vocal cord mobility.T5Tumour limited to the larynx with vocal cord fixation and or invades paraglottic space and or minor thyroid cartilage erosion.T6Tumour invades through thyroid cartilage and or invades tissues beyond the larynx (e. g., trachea, soft tissues of neck including deep extrinsic muscles of the tongue strap muscles, thyroid or oesophagus).T7Tumour incades prevertebral space, encases carotid artery or invades mediastinal structuresSubglottisT1Tomour limited to subglottisT2Tomour extends to vocal cord(s) with normal or impaired mobilityT3Tumour limited to larynx with vocal cord fixationT4Tumour invades cricoid or thyroid cartilage and or invades tissue beyond the larynx (e. g., trachea, soft tissues of neck including deep extrinsic muscle of tongue, strap muscles, thyroid or oesophagus)T5Tomour invades prevertebral space, encases carotid artery or invades mediastinal structuresRegional lymph nodes (N)NxRegional lymph nodes cannot be assessedN0No regional lymph node metastasisN1Metastasis in a single ipsilateral lymph bode, 3 cm or lwss in greatest dimensionN2Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension, or multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension, or bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension.N2aMetastasis in a single ipsilateral lymph node more than 3 cm but not more than 6 cm in greatest dimension. Stage grouping0TisN0M0IT1N0M0IIt2N0M0IIIT3N0M0 T1N1M0 T2N1M0 T3N1M0IVAT4aN0M0 T4aN1M0 T1n2M0 T2N2M0 T3N2M0 T4an2M0IVBT4bAnyNM0 Any TN3M0IVCAny TAnyNM0Histopathologic grace (G)Grade 1W ell-differentiatedGrade 2Moderately differentiatedGrade 3Poortly differentiated* Thus stage I is T1 N0 M0.* Treatment for T1 stage is radiotherapy Subglottic Ca|||T1 & T2 lesionsT3 & T4 lesions||RadiotherapyTL + post op. RT (Radiation portal should include upper mediastinum
Partial laryngectomy
Total laryngectomy
Radiotherapy
Laser ablation
Larynx