The principal goals of the treatment of laryngeal cancer are complete eradication of malignant lesions and maintenance of best phonatory function. The effectiveness of both radiotherapy and surgery are well known, but it is difficult to select the treatment method of best survival associated with the most effective conservation of laryngeal function. In order to give every patient the best possible result, it is important to understand the factors influencing treatment decisions. From 1985 to 1990, a retrospective study was undertaken to analyze 47 patients with laryngeal cancer whoes radiotherapy failed. Factors associated with recurrence were tumor size and invasion to specific laryngeal structure, cervical lymph node metastasis with central necrosis, prolonged radiotherapy duration, sex and poor general condition. Among 13 cases of salvage surgery, 10 cases had been salvaged but three cases failed due to local recurrence and distant metastasis.