Salvage with supracricoid partial laryngectomy after radiation failure

Authors


  • J. Clark FRACS; G. Morgan FRACDS, FRACS; M. Veness FRANZCR; C. Dalton FRACS; I. Kalnins FRACS.

Mr Jonathan Clark, Department of Head and Neck Surgical Oncology, Princess Margaret Hospital, Wharton Head and Neck Centre, 610 University Avenue, 2nd Floor, Toronto, Ontario M5G 2M9, Canada.
Email: jcjc@tpg.com.au

Abstract

Background:  Supracricoid partial laryngectomy (SCPL) is an alternative to total laryngectomy (TL) for selected glottic and supraglottic carcinomas but its role in the setting of radiation failure is unclear. The aim of the present study was to present a series of patients with laryngeal cancer undergoing salvage surgery for local recurrence and examine the morbidity associated with this intervention.

Methods:  A retrospective review of 111 patients presenting with laryngeal cancer between 1997 and 2002 was performed. A total of 21 patients with recurrent disease following radiation therapy were identified, of which salvage surgery was performed in 18 patients. Minimum follow up of survivors was 22 months.

Results:  The 5-year cumulative local control and disease-specific survival was 76% and 85%, respectively. Surgical salvage consisted of TL in 12 patients and SCPL in six. The mortality and major morbidity rates for TL were 0% and 33%, and for SCPL they were 33% and 50%, respectively. Median length of hospital stay was similar in both groups (21 and 19 days). No patient undergoing SCPL developed recurrent disease at a median follow up of 19 months.

Conclusions:  Supracricoid partial laryngectomy is an oncologically sound alternative to TL as salvage for radiation failure. The operative morbidity and potential for mortality is high in this setting.

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