[Clinical analysis of 74 cases of laryngeal cancer who underwent frontolateral partial vertical laryngectomy--usefulness of salvage surgery after failure of a full course of radiotherapy].
This study was designed to analyze the surgical (postoperative course, mortality, morbidity), oncological (local control, survival rate) and functional (maximum phonation time: MPT) results of frontolateral partial vertical laryngectomy (FLPVL), in order to evaluate the advantages and disadvantages of salvage FLPVL after a full course of radiotherapy (FRT). A retrospective analysis of the results in the 74 patients (of whom 61 had previously received FRT) was undertaken. The median follow up was 68 months (range 12-290 months). No significant influence of the prior FRT was noted on the deglutition, respiration, or duration of hospitalization. The frequency of complications after discharge, but not of that during hospitalization was significantly higher in the prior FRT group. Speech (MPT) was significantly shorter (poor effect) in the prior FRT group with standard extirpation. Recurrence developed in 8 patients: in the larynx only in 7 cases, and in both the larynx and neck in the remaining one case. One patient with control of the primary showed relapse in the neck and lung. Subsequent surgery was successful in salvaging 5 of the 8 cases with local failure. One died refusing TL, and two because of uncontrolled neck recurrence. Hence, the overall laryngeal preservation rate following salvage FLPVL was 85% (52/61). Salvage FLPVL results in good tumor control and incompletely satisfactory functional results and may be recognized as a safe procedure.
Miura
Kouki
K
Department of Head and Neck Oncology and Surgery, International University of Health and Welfare, Tokyo.
Kamata
Shin-etsu
SE
Kawabata
Kazuyoshi
K
Tada
Yuuichirou
Y
Masubuti
Tatuo
T
Nakamura
Narihiro
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016879:Salvage Therapy