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A study population of 374 patients with cancer of the larynx was evaluated, treated, and followed at yearly intervals up to a maximum of 18 years post-diagnosis. Of these, 348 received definitive therapy to attempt to eradicate their disease and were followed for recurrence and presence of cancer at death. In Stages I, II, and III recurrence of disease appears to be a very good indicator of therapeutic efficacy. Stage I carcinomas of the larynx should be treated with radiation as the proportions of patients with recurrences were the same for both primary surgical or radiation therapy. In Stages II and III, primary surgical therapy significantly lowered the proportion recurring when compared with primary radiation therapy. In Stage IV carcinomas of the larynx, both survival and recurrence accurately reflect therapeutic efficacy since most patients suffer recurrence of their carcinoma and die of the disease.