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Pathological validation of supracricoid partial laryngectomy in laryngeal cancer
Author(s) -
Sun D.I.,
Cho K.J.,
Cho J.H.,
Joo Y.H.,
Jung C.K.,
Kim M.S.
Publication year - 2009
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/j.1749-4486.2008.01854.x
Subject(s) - medicine , subglottis , thyroid cartilage , anterior commissure , posterior commissure , surgery , glottis , arytenoid cartilage , univariate analysis , pathological , survival rate , larynx , stage (stratigraphy) , cricoid cartilage , laryngectomy , multivariate analysis , vascularity , cancer , biology , paleontology , nucleus , psychiatry
Objectives: To validate pathologically whether supracricoid partial laryngectomy is an oncologically sound procedure in cases with invasion of the thyroid cartilage, paraglottic space, pre‐epiglottic space, anterior commissure, or subglottis. Design: A retrospective review of case notes was performed. Setting: Patients treated at a single institute in the Republic of Korea. Participants: Sixty‐three patients who underwent supracricoid partial laryngectomy for laryngeal squamous cell carcinoma between June 1994 and May 2005 who were followed for at least 2 years. Main outcome measures: Local control and overall survival rates. Pathological invasion of the thyroid cartilage, anterior commissure, pre‐epiglottic space, paraglottic space, or subglottis was also investigated as a cause of recurrence. Prognostic factors for local control and survival were evaluated with univariate and multivariate models. Results: Invasion of the anterior commissure, paraglottic space, thyroid cartilage, pre‐epiglottic space, or subglottis had no significant impact on the recurrence or overall survival rates. The presence of a positive resection margin was significantly associated with recurrence in the univariate and multivariate analyses ( P = 0.026, 0.028, respectively). When considering the prognostic factors influencing survival, the univariate analysis showed that N stage, a positive resection margin and recurrence had significant influences on the overall survival rate ( P = 0.010, 0.0004 and 0.000 respectively). In the multivariate analysis, only recurrence affected the survival rate ( P = 0.002). Conclusion: Supracricoid partial laryngectomy can be used with oncological safety in selected cases of laryngeal cancer with invasion of the anterior commissure, thyroid cartilage, pre‐epiglottic space, paraglottic space, or subglottis.