In the patient, a cT3 cN2b G3 supraglottic laryngeal carcinoma on the left was histologically confirmed during a panendoscopy <2015>. Immediately preoperatively, there was a cN2c neck status sonographically. There was a clear internal cardiologic comorbidity. In our interdisciplinary tumor conference, the primary surgical procedure with laryngectomy was discussed as an alternative to primary RCT. After detailed preoperative discussions, the decision was made to proceed with surgery.