Pathological validation of supracricoid partial laryngectomy in laryngeal cancer.
OBJECTIVE
To validate pathologically whether supracricoid partial laryngectomy is an oncologically sound procedure in cases with invasion of the thyroid cartilage, paraglottic space, pre-epiglottic space, anterior commissure, or subglottis.


METHODS
A retrospective review of case notes was performed.


METHODS
Patients treated at a single institute in the Republic of Korea.


METHODS
Sixty-three patients who underwent supracricoid partial laryngectomy for laryngeal squamous cell carcinoma between June 1994 and May 2005 who were followed for at least 2 years.


METHODS
Local control and overall survival rates. Pathological invasion of the thyroid cartilage, anterior commissure, pre-epiglottic space, paraglottic space, or subglottis was also investigated as a cause of recurrence. Prognostic factors for local control and survival were evaluated with univariate and multivariate models.


RESULTS
Invasion of the anterior commissure, paraglottic space, thyroid cartilage, pre-epiglottic space, or subglottis had no significant impact on the recurrence or overall survival rates. The presence of a positive resection margin was significantly associated with recurrence in the univariate and multivariate analyses (P = 0.026, 0.028, respectively). When considering the prognostic factors influencing survival, the univariate analysis showed that N stage, a positive resection margin and recurrence had significant influences on the overall survival rate (P = 0.010, 0.0004 and 0.000 respectively). In the multivariate analysis, only recurrence affected the survival rate (P = 0.002).


CONCLUSIONS
Supracricoid partial laryngectomy can be used with oncological safety in selected cases of laryngeal cancer with invasion of the anterior commissure, thyroid cartilage, pre-epiglottic space, paraglottic space, or subglottis.
Department of Otolaryngology-Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seocho-Gu, Seoul, Korea.
D-I
DI
Sun
K-J
KJ
Cho
J-H
JH
Cho
Y-H
YH
Joo
C-K
CK
Jung
M-S
MS
Kim
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D003413:Cricoid Cartilage / Q000473:pathology / Q000601:surgery*; D004825:Epiglottis / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005931:Glottis / Q000473:pathology; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D007830:Larynx / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D013957:Thyroid Cartilage / Q000473:pathology