title: [Salvage surgery after failure of partial laryngectomy for laryngeal carcinoma].
abstract: OBJECTIVE
  To study surgical managements, outcomes and the factors affecting prognosis of the primary recurrence following partial laryngectomy for laryngeal carcinoma.
  
  
  METHODS
  The clinical data of 77 patients with salvage surgery for primary recurrence following partial laryngectomy for laryngeal carcinoma were analyzed retrospectively. Fifty-one patients underwent salvage total laryngectomy and other 26 patients with salvage partial laryngectomy. Of them, 19 patients without previous radiotherapy received a combined therapy of surgery and radiotherapy. Survival rates were analyzed using Kaplan-Meier method. Prognosis factors were analyzed by Log-rank test and Cox regression.
  
  
  RESULTS
  After salvage surgery, the 3-and 5-year cumulative overall survival rates were 59.1% and 52.7% respectively, and both the 3- and 5-year local recurrence rates were 30.7%. Most patients (48.4%) died of the failure at the primary sites. Multivariate analysis revealed the advanced T stage at initial presentation and the extra-laryngeal invasion of recurrent tumor were adverse prognostic factors for survival rate and also the advanced T stage at initial presentation influenced local recurrence rate.
  
  
  CONCLUSIONS
  Salvage surgery for the primary recurrence following conservation treatment for laryngeal carcinoma can achieve promising results. Salvage total laryngectomy is the main therapeutic management in most recurrent patients. Salvage partial laryngectomy can achieve sound results in the patients selected carefully.
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China. lwsdoct@yahoo.com.cn
authors.forename: Wen-sheng
authors.initials: WS
authors.lastname: Liu
authors.forename: Zhen-gang
authors.initials: ZG
authors.lastname: Xu
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: Ping-zhang
authors.initials: PZ
authors.lastname: Tang
authors.forename: Guo-fen
authors.initials: GF
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy; D017211:Treatment Failure