Survival and functional results of Pearson's near-total laryngectomy for larynx and pyriform sinus carcinoma.
BACKGROUND
Current treatment for most T3 and T4 transglottic and pyriform sinus carcinomas is total laryngectomy or total laryngectomy with partial pharyngectomy. Voice rehabilitation usually requires the use of a tracheoesophageal puncture (TEP). Pearson's near-total laryngectomy (NTL) is an option for voice preservation in selected cases with no invasion of the interarythenoid space and limited invasion of the subglottis. The purpose of this study is to report the functional and survival results of 42 consecutive patients who underwent NTL from 1988 to 1995. Patients and Methods The patients were 40 men and two women, with a median age of 58 years. All patients had squamous cell carcinoma. There were 37 larynx and five pyriform sinus tumors. T3 stage tumor represented 85.7% of the cases.


RESULTS
There were complications in 13 patients (28.9%). Vocal quality was considered good in 83.3% of the cases. To date, eight patients presented tumor recurrences: two local, two in the neck, and four distant. The 5-year actuarial overall survival rates were of 81.7% in larynx carcinoma and 66.6% in pyriform sinus carcinoma.


CONCLUSIONS
In selected transglottic and pyriform sinus carcinomas, NTL can be carried out with acceptable morbidity and a high potential of voice preservation and tumor control.
Andrade
R P
RP
Head and Neck Surgery Department, Hospital A. C. Camargo, Fundaçao Antônio Prudente, São Paulo, Brazil.
Kowalski
L P
LP
Vieira
L J
LJ
Santos
C R
CR
D000328:Adult; D000368:Aged; D001938:Brazil; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013060:Speech; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D014705:Verbal Behavior / Q000502:physiology*