Open AccessSalvage Laryngectomy Outcomes in Recurrent Laryngeal Cancer
Author(s) -
Li Mingsi,
Lorenz Robert R.,
Khan Mumtaz J.,
Burkey Brian B.,
Adelstein David J.,
Scharpf Joseph
Publication year - 2012
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599812451438a94
Subject(s) - medicine , laryngectomy , neck dissection , surgery , cancer , salvage therapy , larynx , survival rate , retrospective cohort study , complication , stage (stratigraphy) , chemotherapy , paleontology , biology
Objective To investigate the effectiveness of salvage partial laryngectomy (PL) and total laryngectomy (TL) in the treatment of recurrent laryngeal cancer in terms of disease control, postoperative course, survival, and functional outcomes, and to identify additional factors influencing the long‐term survival and disease recurrence in patients receiving salvage laryngectomy. Method Retrospective chart review of patients with recurrent squamous cell carcinoma (SCC) of the larynx receiving salvage laryngectomy at Cleveland Clinic from 1997 to 2011. Disease‐specific survival (DSS), overall survival (OS), functional outcomes, recurrence rate, and postoperative course were evaluated against the methods of primary site and neck treatment. Results The series is composed of 109 patients. The 5‐year DSS and 5‐year OS rates were 70.2% and 62.9%, respectively. Laryngeal preservation rate after PL was 80%, with 34% overall complication rate for all patients. No significant differences were noted in 5‐year OS ( P =. 3241), postsalvage recurrence rate ( P =. 3374), postoperative course, or functional outcomes between salvage TL and PL. Five‐year DSS was higher in the PL group ( P =. 0309). Primary tumor location, presalvage treatment, initial/recurrent T‐staging, and neck dissection were not significant predictors of survival or recurrence ( P = NS), but positive nodal disease ( P =. 0320), rN‐staging ( P =. 0474), and postsalvage recurrence ( P <. 0001) were predictors of worse prognosis. Conclusion Salvage PL and TL are both effective procedures in treatment of recurrent laryngeal cancer after treatment failure, with similar efficacy in disease control, survival, functional outcomes, and complication rate in highly selected patients.