title: Results of surgical salvage for radiation failures of laryngeal carcinoma.
abstract: The results of surgical salvage of radiation failures of laryngeal carcinoma were reviewed. There were 167 stage T3 and T4 patients. The operative mortality was 7%. The complication rates were 8% wound infection, 13% chest complication, and 25% anastomotic leakage. After the first salvage operation, pharyngeal recurrence developed in 28 (18%) patients. Seven (25%) patients were feasible for second salvage operation, and none of them had further local recurrence. There were 9 (5%) tracheostomal recurrences. Of the 126 N0 patients, 23 (18%) had nodal recurrence, and only 5 of the nodal recurrences were feasible for salvage by radical neck dissection. All 41 node-positive patients underwent radical neck dissection, and 9 (23%) had nodal recurrence. Of the 126 node-negative patients, 19 (15%) had distant metastasis. Of the 41 node-positive patients, 18 (44%) had distant metastasis. The node-positive patients had a significantly high distant failure rate despite locoregional control of tumor. The adjusted 5-year survival rate of T3-4N0M0 was 45%, and that of T3-4N + M0 was 22%.
authors.affiliation: Department of Surgery, University of Hong Kong, Queen Mary Hospital.
authors.forename: A P
authors.initials: AP
authors.lastname: Yuen
authors.forename: W I
authors.initials: WI
authors.lastname: Wei
authors.forename: C M
authors.initials: CM
authors.lastname: Ho
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000601:surgery; D010611:Pharyngectomy / Q000009:adverse effects; D016879:Salvage Therapy; D013524:Surgical Flaps / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000209:etiology; D015996:Survival Rate; D014134:Tracheal Neoplasms / Q000601:surgery; D014139:Tracheostomy / Q000009:adverse effects; D017211:Treatment Failure