Re: Randomized trial of induction chemotherapy with cisplatin and 5-fluorouracil with or without docetaxel for larynx preservation.

Pointreau et al. (1) clearly showed that docetaxel, cisplatin, and 5-fluorouracil (TPF) is better than PF for larynx preservation in their important phase III study. Unfortunately, we are only given results for larynx preservation as an indicator of a successful laryngeal outcome. It is important to address the issue of laryngectomy-free survival, too, because that endpoint has broader implications. Laryngectomy-free survival accounts for those patients who survived with an intact and functional larynx instead of only focusing on those with a preserved larynx. Two endpoints that are considered by many to be important in larynx preservation trials are not presented in the study. These are prolonged trache-otomy and permanent percutaneous endo-scopic gastrostomy dependency (2 , 3). Interpretation and implication of the results of the trial will be strengthened by these data. It is also not clear why a total larynge-ctomy was chosen as the operation of choice for these patients instead of a partial laryngectomy in which a portion of the larynx was preserved. Finally, five patients