title: Role of surgical salvage for regional recurrence in laryngeal cancer.
abstract: OBJECTIVE
  The aims of this study were to analyze the pattern of regional recurrence in laryngeal cancer, evaluate the role of surgical salvage, and identify factors affecting salvage outcome.
  
  
  METHODS
  Retrospective analysis was conducted on medical records from a 16-year period. Of 463 patients diagnosed with laryngeal cancer, 25 patients with regional recurrence managed with salvage neck dissection were identified and subject to study. Isolated local recurrences and all distant metastases were excluded.
  
  
  RESULTS
  All patients were male with a median age of 61 years. The overall rate of regional recurrence was 5.4%. Median time to regional recurrence was 13 months. Isolated regional recurrence occurred in 76% of cases, whereas locoregional recurrence occurred in 24%. A 5-year survival rate for patients undergoing neck dissection as salvage management was 61.2%. Patients with recurrence in the contralateral neck were definitely associated with poor prognosis. Although standard statistical significance was not met, trends for poorer salvage result were identified in patients with a history of local recurrence before regional recurrence, recurrence in a previously dissected neck, and recurred node size of 3 cm or above.
  
  
  CONCLUSIONS
  Our study shows that salvage neck dissection for regional recurrence in laryngeal cancer is an acceptable approach. Surgical eradication of disease should be warranted whenever possible. Prudent planning of management is mandatory in the presence of history of local recurrence before regional recurrence, previously dissected neck, large size of recurrent node, and contralateral neck recurrence.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Woo-Jin
authors.initials: WJ
authors.lastname: Jeong
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Jung
authors.forename: Seong Keun
authors.initials: SK
authors.lastname: Kwon
authors.forename: J Hun
authors.initials: JH
authors.lastname: Hah
authors.forename: Tack-Kyun
authors.initials: TK
authors.lastname: Kwon
authors.forename: Myung-Whun
authors.initials: MW
authors.lastname: Sung
authors.forename: Kwang Hyun
authors.initials: KH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000401:mortality; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate