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Salvage surgery for recurrent larynx cancer
Author(s) -
Mimica Ximena,
Hanson Martin,
Patel Snehal G.,
McGill Marlena,
McBride Sean,
Lee Nancy,
Dunn Lara A.,
Cracchiolo Jennifer R.,
Shah Jatin P.,
Wong Richard J.,
Ganly Ian,
Cohen Marc A.
Publication year - 2019
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.25925
Subject(s) - medicine , laryngectomy , salvage surgery , perineural invasion , larynx , surgery , stage (stratigraphy) , cancer , radiation therapy , salvage therapy , overall survival , chemotherapy , paleontology , biology
Background Despite advances in treatment, the recurrence rates for laryngeal cancer range from 16% to 40%. Methods Patients with recurrent laryngeal cancer treated at Memorial Sloan Kettering (MSK) from 1999 to 2016 were reviewed. Survival outcomes were analyzed. Results Of 241 patients, 88% were male; the median age was 67 years; 71% had primary glottic tumors. At initial treatment, 72% of patients were seen with early stage disease; primary treatment was radiation (68%), chemoradiation (29%), and surgery (3%). The most common salvage surgery was total laryngectomy (74%). Forty‐seven percentage were upstaged at salvage surgery. The 2‐ and 5‐year disease‐specific survival (DSS) was 74% and 57%, respectively. Patients with cT4 disease treated with nonsurgical primary management had a 0% 5‐year DSS. Independent predictors of DSS were tumor location, perineural invasion, margin, and stage. Conclusions Salvage surgery results in acceptable oncologic outcomes. Stage, disease site, perineural invasion, and margins are associated with inferior DSS.