Near-total laryngectomy for laryngeal carcinomas with subglottic extension.
OBJECTIVE
To investigate whether Pearson classic near-total laryngectomy is a sensible surgical treatment modality for laryngeal carcinomas with subglottic extension.


METHODS
Retrospective analysis of patients treated by near-total laryngectomy in a university hospital that is an academic tertiary health care center.


METHODS
Medical and computer records of 135 patients who were treated by near-total laryngectomy for laryngeal and hypopharyngeal carcinomas between April 1, 1989, and June 30, 2000, were searched thoroughly, and the final outcomes were confirmed by telephone contact.


METHODS
Survival rates of the patients with laryngeal carcinomas with subglottic extension treated by near-total laryngectomy were compared with those of the patients with malignancies of other laryngeal regions given the same treatment.


RESULTS
Of the 135 patients in the study, 74 were available for determination of 5-year survival. The rate was 65.8% (27/41) for transglottic tumors, 53.8% (7/13) for supraglottic tumors, and 20.0% (4/20) for tumors with subglottic extension. Only 3 of 16 patients with laryngeal carcinomas with supraglottic or transglottic localization died of local recurrence; the rest of the deaths were from regional recurrence or distant metastasis. However, 6 of 13 patients with subglottic extension died of local recurrence, 5 of peristomal recurrence, and only 2 of distant metastasis.


CONCLUSIONS
Success was directly related to adherence to precise indications in cancer surgery. While near-total laryngectomy is an effective and reliable treatment modality in laryngeal cancer surgery, its effectiveness in laryngeal cancers with subglottic extension is debatable. These subglottic lesions should be treated by total laryngectomy, which is a more radical surgery.
Aslan
Ismet
I
Department of Otorhinolaryngology, Faculty of Medicine, Istanbul University, Kardelen 4-5 D: 3, 81120 Atasehir Istanbul, Turkey. ismetaslan@istanbul.edu.tr
Baserer
Nermin
N
Yazicioglu
Engin
E
Oysu
Cagatay
C
Tinaz
Mehmet
M
Kiyak
Erkan
E
Biliciler
Necdet
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005931:Glottis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy; D007830:Larynx / Q000473:pathology / Q000601:surgery*; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome