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Diagnosis and treatment of recurrent laryngeal cancer following initial nonsurgical therapy
Author(s) -
Agra Ivan Marcelo Gonçalves,
Ferlito Alfio,
Takes Robert P.,
Silver Carl E.,
Olsen Kerry D.,
Stoeckli Sandro J.,
Strojan Primož,
Rodrigo Juan P.,
Gonçalves Filho João,
Genden Eric M.,
Haigentz Missak,
Khafif Avi,
Weber Randal S.,
Zbären Peter,
Suárez Carlos,
Hartl Dana M.,
Rinaldo Alessandra,
Kim Kwang Hyun,
Kowalski Luiz P.
Publication year - 2012
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21739
Subject(s) - medicine , laryngectomy , surgery , stage (stratigraphy) , radiation therapy , cancer , larynx , laser surgery , paleontology , laser , physics , optics , biology
Surgery is the preferred modality for curative treatment of recurrent laryngeal cancer after failure of nonsurgical treatments. Patients with initial early‐stage cancer experiencing recurrence following radiotherapy often have more advanced‐stage tumors by the time the recurrence is recognized. About one third of such recurrent cancers are suitable for conservation surgery. Endoscopic resection with the CO 2 laser or open partial laryngectomy (partial vertical, supracricoid, or supraglottic laryngectomies) have been used. The outcomes of conservation surgery appear better than those after total laryngectomy, because of selection bias. Transoral laser surgery is currently used more frequently than open partial laryngectomy for treatment of early‐stage recurrence, with outcomes equivalent to open surgery but with less associated morbidity. Laser surgery has also been employed for selective cases of advanced recurrent disease, but patient selection and expertise are required for application of this modality to rT3 tumors. In general, conservation laryngeal surgery is a safe and effective treatment for localized recurrences after radiotherapy for early‐stage glottic cancer. Recurrent advanced‐stage cancers should generally be treated by total laryngectomy. © 2011 Wiley Periodicals, Inc. Head Neck, 2012.