Significance of laryngeal edema after partial laryngectomy and radiotherapy in supraglottic cancer.
OBJECTIVE
To evaluate the impact of the presence of laryngeal edema on outcome and the other potential prognostic factors in patients with supraglottic larynx carcinoma treated with radiotherapy after partial laryngectomy.


METHODS
A retrospective analysis.


METHODS
Cerrahpaşa Medical Faculty, Istanbul University.


METHODS
Seventy-nine patients with supraglottic carcinoma of the larynx were treated with radiotherapy after partial laryngectomy between January 1980 and July 2003. Neck dissection was not performed in 46 patients. The median follow-up time was 64 months.


METHODS
The effect of laryngeal edema grade on local control, disease-free, and actuarial survival rates.


RESULTS
The 5-year locoregional progression-free and overall survival rates were 86% and 75%, respectively. In univariate analysis, histologically positive neck disease reduced regional (p = .0045) and disease-free survival (p = .01). Patients with edema grade III-IV had lower local control (p = .0004), disease-free (p = .0034), and actuarial survival (p = .0041) rates. In the multivariate analysis, a significant negative association of laryngeal edema with local control (p = .012), disease-free survival (p = .002), and actuarial survival (p = .003) was found. Nodal status was a significant prognostic factor for disease-free survival (p = .027). Grade III-IV laryngeal edema was observed in 17 patients. Owing to laryngeal edema, tracheostomy dependence and total laryngectomy were required in three patients and one patient, respectively.


CONCLUSIONS
Radiotherapy after partial laryngectomy can be performed in patients with poor prognostic factors with reasonable complication rates. However, in the presence of grade III-IV laryngeal edema, tumour recurrence should be suspected, and these patients have to be managed with close follow-up and further evaluation to improve outcome.
Oksüz
Didem Colpan
DC
Department of Radiation Oncology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey. didemcolpan@yahoo.com
Uzel
Omer
O
Yildirim
Ayşe
A
Yetmen
Ozlem
O
Sahinler
Ismet
I
Turkan
Sedat
S
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007819:Laryngeal Edema / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D007825:Laryngectomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011184:Postoperative Period; D011336:Probability; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome