Early glottic carcinoma treated with open laryngeal procedures.
OBJECTIVE
The purpose of this study was to determine the recurrence rate and long-term survival of patients treated with open cervical procedures.


METHODS
The study is a retrospective analysis of a cohort of patients who underwent an open laryngeal procedure between 1976 and 1986. The median follow-up was 6.6 years.


METHODS
The sample was a consecutive series of 159 patients with early glottic carcinoma without impaired vocal cord mobility. Patients with a history of radiation therapy or surgical treatment elsewhere were excluded.


METHODS
Surgical treatment in this group of 159 patients included 82 frontolateral partial vertical laryngectomies, 61 laryngofissures with cordectomy, 12 hemilaryngectomies, and four anterior commissure procedures.


METHODS
Estimates of survival time beyond the day of surgery, time to first recurrence (local, regional, and distant), and time to first local recurrence were obtained with the Kaplan-Meier product-limit method.


RESULTS
Eleven patients experienced recurrent laryngeal cancer. Ten patients underwent laryngectomy for recurrence. One patient underwent an anterior commissure procedure. Three of the 11 patients who underwent re-treatment of the larynx were ultimately salvaged. The probability of survival at 3 and 5 years was 91% and 84%, respectively. The probability of remaining free of local recurrence 3 and 5 years after surgery was 94% and 93%, respectively.


CONCLUSIONS
In our experience, open laryngeal procedures continue to be excellent treatment for select cases of early glottic carcinoma. They are versatile and efficacious for managing the wide spectrum of larger T1 glottic carcinomas.
Thomas
J V
JV
Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minn.
Olsen
K D
KD
Neel
H B
HB
DeSanto
L W
LW
Suman
V J
VJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005931:Glottis / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis