Evaluation of risk factors for stomal recurrence after total laryngectomy.
The development of a stomal recurrence after total laryngectomy is a complication with a dismal prognosis. The risk factors and mechanisms involved are still not well understood. In this review of 352 patients, 21 (6%) developed a stomal recurrence. We studied the group of 74 patients (21%) with subglottic involvement separately. There was no significant difference in the rate of stomal recurrence in those with emergency tracheostomy (23.3%) as compared with those with intra-operative tracheostomy (18.2%). Stomal recurrence was more strongly associated with subglottic involvement itself (20.3%) and T4 stage (15.3%). The findings suggest that submucosal extension and lymph node metastases are probably more important mechanisms of stomal recurrence than cancer cell implantation.
Yotakis
J
J
ENT Clinic, University of Athens, Greece.
Davris
S
S
Kontozoglou
T
T
Adamopoulos
G
G
D004630:Emergencies; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care; D007820:Laryngeal Mucosa / Q000473:pathology; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D014139:Tracheostomy