[Primary coblat therapy and secondary surgery for supra-glottal carcinoma (author's transl)].

This statistical study concerned 218 carcinomas of the laryngeal vestibule and margin treated at the Curie Foundation between 1958 and 1967, by primary cobalt therapy followed when necessary by secondary total laryngectomy. It shows that cobalt therapy alone gives excellent results in early forms (T1 and T2) even in the presence of N1 or N2 nodes. By contrast, the proportion of cures is much lower in T3 and T4 forms. Secondary total laryngectomy was used in only 25 cases out of 127 failures. The postoperative course was often difficult (4 fatal complications and 3 pharyngostomies) but 7 of the patients were cured at 5 years. The use of a surgical technique with minimal trauma and in particular respecting the integrity of the carotid gutters has been associated, in a more recent series, with a notable improvement in the results obtained (one cure out of 2 at 3 years).