Early pharyngolaryngeal carcinomas with palpable nodes. French Head and Neck Study Group (GETTEC).

Three hundred thirteen patients with T1 or T2 tumors of the piriform fossa (n = 181) or epilarynx (n = 132), all with involved nodes (57 N1, 101 N2a, 52 N2b, 25 N2c, 76 N3), were included in a multicenter study. Twenty-one percent were treated with radical neck dissection and radiotherapy to the neck and tumor, 17% by partial laryngeal surgery and radical neck dissection plus postoperative radiotherapy (RT), and 62% by RT only, with surgery in reserve. After treatment, residual tumor was present in 26 patients and residual nodes in 24. Recurrences were local in 27 patients and nodal in 46. Distant metastasis occurred in 28% of the patients. Among 173 patients who died, local failure occurred in 45 (isolated in 20), nodal failure in 70 (isolated in 39), and distant metastasis in 95 (isolated in 68). The median survival was 18 months. The survival rate of the 313 patients was 32% at 3 years and 18% at 5 years, with no difference according to location, protocol, nodal level, or regional nodal status, except for the 76 patients with N3 disease (3-year survival: 17%).