A nine-year institutional experience with near-total laryngectomy.
BACKGROUND
Pearson's near-total laryngectomy (NTL) is an alternative procedure to total laryngectomy in selected patients with advanced laryngeal cancer. Based on our experience with NTL for >9 years, we present here the functional results, complications, and survival rates.


METHODS
A retrospective study was carried out from January 1993 to May 2002. We studied 15 patients with advanced laryngeal, oropharyngeal, and hypopharyngeal cancer who underwent NTL. Survival rates were calculated using the Kaplan-Meier method.


RESULTS
The most common complication was fistula (8 of 15) followed by minor aspiration (4 of 15 patients). Eleven patients (73.5%) attained a good voice; 3 patients (19.9%) obtained a bad voice; and 1 did not achieved vocal ability. Three patients (19.9%) had local recurrence; no patients had neck recurrence; and 2 patients (13.3%) had distant metastasis. Six patients (40%) died from their disease, and 2 (13.3%) patients died from other causes. The 3-year actuarial survival rate was 81.6%.


CONCLUSIONS
NTL is useful in the treatment of selected patients with advanced laryngeal, oropharyngeal, and hypopharyngeal cancer and results in good control and survival rates. Satisfactory functional results can be attained in the majority of patients. When the surgical margins are positive or close, TL must be carried out.
Kavabata
Norberto K
NK
Head and Neck Surgery Unit, Department of Surgery, Santa Casa de São Paulo-Faculty Medical Sciences, Rua Dr. Cesáreo Mota Junior 112, CEP 01221-900, São Paulo, Brazil. kavabata@terra.co.br
Silva Neto
Abilio L
AL
Gonçalves
Antonio J
AJ
Alcadipani
Fernando A M C
FA
Menezes
Marcelo Benedito
MB
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D017577:Cutaneous Fistula / Q000209:etiology; D005260:Female; D005402:Fistula / Q000209:etiology; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D010608:Pharyngeal Diseases / Q000209:etiology; D012189:Retrospective Studies; D014833:Voice Quality