Supracricoid laryngectomy with CHEP: functional results and outcome.
OBJECTIVE
To assess whether supracricoid laryngectomy with cricohiodoepiglottopexy could successfully reach the cure and preserve the voice in glottic laryngeal cancer, we studied 27 patients with T2/T3 squamous cell carcinoma of the larynx treated in our institution with cricohiodoepiglottopexy.


METHODS
A retrospective analysis has been carried out between 1995 through 1997. We classified 11 patients as T2N0M0 and 16 patients as T3N0M0. Nineteen patients had bilateral selective lateral neck dissection, 3 patients had unilateral lateral neck dissection, and 5 patients had undissected neck. Survival was analyzed under the Kaplan-Meyer method.


RESULTS
Five patients had postoperative complications, 2 were treated with a total laryngectomy. The remaining 25 patients kept the normal airway, swallowing, and speech. None of the patients in the neck dissection group had neck metastasis. Two patients had recurrences, 1 with local recurrence was treated with a total laryngectomy and is alive without disease; the other patient had neck recurrence, was treated with radical neck dissection plus radiotherapy, and is dead of the disease. One patient had a second tumor in oropharynx treated with palliative radiotherapy and is dead of the disease. Three years disease-free survival was 75% for T2 and 79% for T3.


CONCLUSIONS
This technique is useful in the treatment of selected cases of T3/T2 glottic cancer regarding the extent of disease. The incidence of complications in need of a complete laryngectomy does not compromise the functionality of this technique. The survival is comparable to patients who submitted to total laryngectomy and near-total laryngectomy, regarding the extent of the lesion.
Head and Neck Service, Hospital do Cancer, National Cancer Institute/INCA, Rio de Janeiro, Brazil. rlima@iis.com.br
R A
RA
Lima
E Q
EQ
Freitas
J
J
Kligerman
F L
FL
Dias
M M
MM
Barbosa
G M
GM
Sa
I C
IC
Santos
T
T
Farias
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D003413:Cricoid Cartilage / Q000601:surgery*; D018572:Disease-Free Survival; D004825:Epiglottis / Q000601:surgery*; D005260:Female; D005931:Glottis / Q000601:surgery*; D006801:Humans; D006928:Hyoid Bone / Q000601:surgery*; D015994:Incidence; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome