Partial laryngectomy to treat early glottic cancer after failure of radiation therapy

Arch Otolaryngol Head Neck Surg. 2002 Aug;128(8):909-12. doi: 10.1001/archotol.128.8.909.

Abstract

Objective: To evaluate the role of partial laryngectomy to treat glottic cancer after failure of radiation therapy.

Design: A 12-year retrospective outcome analysis.

Setting: University referral center.

Patients: A total of 19 patients who underwent partial laryngectomy to treat glottic cancer after failure of radiation therapy.

Results: The follow-up period in this group ranged from 31 to 144 months. After surgery, a laryngocutaneous fistula was observed in 4 cases, and flap necrosis occurred in 2, but these complications were successfully managed. Maximum phonation time after surgery ranged from 3 to 28 seconds (median phonation time, 10.2 seconds). Of these 19 patients, 3 developed local recurrence. These cases were successfully treated with total laryngectomy. A surgical margin of less than 1 mm was found to be a significant risk factor for local recurrence after partial laryngectomy.

Conclusions: These results indicate that partial laryngectomy is a useful option for the treatment of irradiation failure in the treatment of stage I and stage II vocal cord carcinomas. However, careful follow-up is mandatory for patients with a small surgical margin.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / physiopathology*
  • Carcinoma, Squamous Cell / therapy*
  • Follow-Up Studies
  • Glottis / physiopathology
  • Glottis / radiation effects*
  • Glottis / surgery*
  • Humans
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / physiopathology*
  • Laryngeal Neoplasms / therapy*
  • Laryngectomy / adverse effects*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / physiopathology*
  • Neoplasm Recurrence, Local / therapy*
  • Outcome and Process Assessment, Health Care
  • Postoperative Complications*
  • Recovery of Function / physiology
  • Retrospective Studies
  • Salvage Therapy
  • Survival Rate
  • Time Factors
  • Treatment Failure