All involved physicians must be aware of the high incidence of multicentric lesions and of co-existing invasive carcinoma in the larynx of these patients. Radiation therapy is the treatment of choice for this condition. The patient has stopped smoking. There is no possibility that the patient will be lost to follow-up. Bilateral in situ disease is an absolute indication for radiation treatment.
Primary treatment is by radiation therapy.
Partial or total laryngectomy is reserved for persistent or recurrent disease depending on the disease itself and the condition of the patient, although could be an option in selected cases as a primary treatment. These patients often require a combination of a planned course of radiation and surgery. Many patients may be curable by radiation or surgery alone and selection of the treatment modality in each patient will require a multidisciplinary assessment. A small single node located within the radiation field may be cured by radiation alone, but larger or multiple nodes will require radical neck dissection. Surgery for persistent or recurrent disease will require radical resection of the primary and neck dissection.