title: Factors influencing long-term survival following salvage total laryngectomy after initial radiotherapy or conservative surgery.
abstract: BACKGROUND
  This retrospective study investigated survival outcomes of salvage total laryngectomy (STL) after initial radiation therapy (RT) or larynx conservation surgery (CS) at an academic center.
  
  
  METHODS
  A chart review yielded 64 patients with STL: 53 with RT failures, six with CS failures, and five after RT + CS. Median potential follow-up after STL was 9.4 years (mean, 9.2 years; range, 0.3-17.4 years).
  
  
  RESULTS
  Five- and 10-year actuarial overall survival (OS) after STL was 65.2% and 37.7%, respectively. Mean survival after STL was 7.2 years (median, 6.8 years; range, 0.2-17.4 years). No significant survival difference was found between the three treatment groups (p = .50). For 21 patients with nodes assessed at STL, 9-year OS was 45.4% for patients with N0 disease versus 26.7% for patients with N+ disease (p = .25).
  
  
  CONCLUSIONS
  These data suggest that STL after radiation failure is associated with equivalent long-term survival as STL after RT + CS or after failure of CS alone.
authors.affiliation: Department of Radiation Oncology, Emory University School of Medicine, 1365 Clifton Road NE, Atlanta, GA 30322, USA.
authors.forename: B Zach
authors.initials: BZ
authors.lastname: Fowler
authors.forename: Susan
authors.initials: S
authors.lastname: Muller
authors.forename: Amy Y
authors.initials: AY
authors.lastname: Chen
authors.forename: Peter A S
authors.initials: PA
authors.lastname: Johnstone
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate