The precise figure depends on T stage. The true vocal cords are devoid of lymphatics. As a result, vocal cord cancer confined to the true cords rarely, if ever, presents with involved lymph nodes. Extension above or below the cords may, however, lead to lymph node involvement. No survival advantage has yet been demonstrated, however, in part because of recurrence and death from the primary malignancy.
Additional trials are ongoing.
Supraglottic cancers typically present with sore throat, painful swallowing, referred ear pain, change in voice quality, or enlarged neck nodes. Early vocal cord cancers are usually detected because of hoarseness. The most important adverse prognostic factors for laryngeal cancers include increasing T stage and N stage. Although most early lesions can be cured by either radiation therapy or surgery, radiation therapy may be reasonable to preserve the voice, leaving surgery for salvage. This observation is being evaluated in a randomized clinical trial.