Treatment of choice for laryngeal carcinoma of glottis extending to supraglottic region with vocal cord fixation with papable solitary’ ipsilateral lymph node is –
**Core Concept**
The question is testing the management of laryngeal carcinoma, specifically the glottic type that has spread to the supraglottic region and is associated with vocal cord fixation and a solitary lymph node. This scenario involves a T3 or T4 tumor with N1 lymph node involvement, requiring a comprehensive treatment plan.
**Why the Correct Answer is Right**
The treatment of choice for this scenario involves a multidisciplinary approach. Given the vocal cord fixation and the presence of a solitary lymph node, the primary goal is to achieve local control of the tumor while considering the risk of recurrence and the impact on the patient's quality of life. The correct answer involves a combination of chemoradiation and surgery.
In this case, the patient is a candidate for total laryngectomy with neck dissection. The goal of surgery is to remove the primary tumor, the involved lymph node, and a portion of the surrounding tissue to achieve clear margins. Chemoradiation is used as an adjunct to surgery to reduce the risk of local recurrence.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because it does not address the need for surgery in the presence of vocal cord fixation and a solitary lymph node. Chemotherapy alone may not be sufficient in this scenario.
**Option B:** This option is incorrect because it does not consider the need for a comprehensive treatment approach that includes surgery and chemoradiation.
**Option C:** This option is incorrect because it does not address the need for neck dissection in the presence of a solitary lymph node.
**Clinical Pearl / High-Yield Fact**
The management of laryngeal carcinoma requires a thorough understanding of the tumor's extent and the patient's overall health status. In this scenario, the patient's vocal cord fixation and solitary lymph node involvement necessitate a more aggressive treatment approach.
**Correct Answer:** C. Total laryngectomy with neck dissection.