Supracricoid laryngectomy with cricohyoidoepiglottopexy for advanced glottic cancer.
BACKGROUND
Supracricoid laryngectomy with cri-cohyoidoepiglottopexy (CHEP) is a conservative surgical procedure indicated in selected cases of advanced glottic carcinoma.


METHODS
This study is a review of our experience with 43 patients with T3/T4 glottic squamous cell carcinoma who underwent CHEP in our institution. All but two patients underwent selective neck dissections. All patients were staged on the basis of the 2002 TNM classification. Rates of recurrence and death were estimated by the Kaplan-Meier method.


RESULTS
The 5-year disease-specific survival and 5-year relapse-free survival rates were 78% and 83%, respectively. Neck metastases were found in three patients. Cartilage invasion occurred in 11 cases. The average length of hospital stay was 5.7 days. The mean time of enteral feeding tube was 33.8 days, and the mean time for tracheotomy was 29.6 days. Overall, normal swallowing was achieved in 74.4% of patients. Eleven patients had mild and major complications. Laryngeal stenosis emerged as the most frequent major complication. Three patients (6.9%) had local recurrences. Two patients (4.6%) had neck metastases.


CONCLUSIONS
On the basis of this study, over a 7-year period with 43 patients with advanced glottic cancer, a successful on-cologic outcome is confirmed.
Lima
Roberto A
RA
Head and Neck Surgery Service, Brazilian National Cancer Institute/INCA, Avenida Armando Lombardi, 1000 Bloco 2/107, Barra, 22640-000, Rio de Janeiro, RJ, Brazil. rlimamd@globo.com
Freitas
Emilson Q
EQ
Dias
Fernando L
FL
Barbosa
Mauro M
MM
Kligerman
Jacob
J
Soares
Jose R
JR
Santos
Izabella C
IC
Rocha
Ricardo M
RM
Cernea
Claudio R
CR
D000368:Aged; D000369:Aged, 80 and over; D001193:Arytenoid Cartilage / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D003413:Cricoid Cartilage / Q000601:surgery; D018572:Disease-Free Survival; D004825:Epiglottis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods*; D007829:Laryngostenosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications / Q000209:etiology; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome