Background. The long‐term survival of 81 patients with T3 squamous cell carcinoma of the glottic larynx treated with laryngectomy alone is presented and pathologic predictors for cancer recurrence above the clavicles and cancer death are identified. Methods. Clinical records, operative notes, and pathologic slides were reviewed. The major end points were failure above the clavicles, cause‐specific survival, and overall survival. All patients were followed until death or a minimum of 10.8 years. Results. The main pattern of treatment failure was within an undissected ipsilateral or contralateral neck. Subglottic extension and nodal metastases predicted failure above the clavicles and delayed metastasis within an undissected neck. The 5‐year rate of control of disease above the clavicles, cause‐specific survival, and overall survival were 74.1%, 73.7%, and 54.3%, respectively. Conclusions. Patients treated with laryngectomy for T3 glottic cancer who have pathologic evidence of subglottic extension or nodal metastasis are at higher risk for recurrence above the clavicles, particularly within an undissected neck. © 1994 John Wiley & Sons, Inc.
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