Stage III 
Standard Treatment 
• Supraglottis: Standard therapy is surgery with postoperative radiotherapy , but many centers are now treating
  some patients with external beam radiotherapy initially, depending on the tumor location and patient status.
  The voice is preserved in about half of these patients. If this treatment is unsuccessful, surgery is necessary.
      Investigational protocols are using chemotherapy , hyperfractionated radiotherapy, radiation sensitizers, and
  particle beam radiotherapy.
• Glottis: Surgery with postoperative radiotherapy, if necessary for the primary site and/or positive lymph
  nodes . Patients who refuse or cannot tolerate surgery are given radiation therapy .
      Again, many centers are treating selected patients with radiotherapy as primary treatment. Careful
  follow-up is vital, since surgery is needed if the tumor recurs.
• Subglottis: Laryngectomy , including also thyroidectomy and tracheoesophageal lymph node dissection, all
  followed by radiotherapy. Some patients are not candidates for surgery and are treated with radiotherapy 
  alone, but surgical treatment may still be needed if there is a recurrence . The Stage III investigational protocols
  described under supraglottic tumors should be considered.

Three-Year Survival  45 to 75 percent (supraglottis), 55 to 70 percent (glottis), no data for subglottis