Supracricoid partial laryngectomy with cricohyoidoepiglottopexy in patients with radiation therapy failure.
BACKGROUND
To assess functional results, complications, and success of larynx preservation in patients with recurrent squamous cell carcinoma after radiotherapy.


METHODS
From a database of 40 patients who underwent supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) from June 2001 to April 2006, eight patients were treated previously with radiotherapy due to squamous cell carcinoma of the glottic region and were treated for recurrence at the site of the primary cancer.


RESULTS
SCPL with CHEP was performed in six men and two women with a mean age of 67 years due to recurrence and/or persistence at a mean time of 30 months postradiotherapy (in case #8 after concomitant chemoradiotherapy). Bilateral neck dissection at levels II-V was performed in six patients. Only case #8 presented metastasis in one node. In case #5, Delphian node was positive. It was possible to preserve both arytenoids in five cases. Definitive surgical margins were negative. Complications were encountered in seven patients. Follow-up was on average 44 months (range: 20-67 months). Organ preservation in this series was 75%, and local control was 87%. Overall 5-year survival was 50%.


CONCLUSIONS
In selected patient with persistence and/or recurrence after radiotherapy due to cancer of the larynx, SCPL with CHEP seems to be feasible with acceptable local control and toxicity. Complications may occur as in previously non-irradiated patients. These complications must be treated conservatively to avoid altering laryngeal function.
Luna-Ortiz
Kuauhyama
K
Department of Head and Neck Surgery, Instituto Nacional de Cancerología (Mexico), Av, San Fernando #22, Tlalpan, Mexico, D,F,, 14080, Mexico. kuauhyama@starmedia.com
Pasche
Philippe
P
Tamez-Velarde
Mario
M
Villavicencio-Valencia
Veronica
V
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D003413:Cricoid Cartilage / Q000473:pathology / Q000528:radiation effects / Q000601:surgery*; D003679:Deglutition; D004825:Epiglottis; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery*; D009381:Neoplasms, Radiation-Induced / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery*; D016879:Salvage Therapy; D017211:Treatment Failure