title: One hundred supracricoid laryngectomies with cricohyoidoepiglottopexy: do we achieve better local control?
abstract: OBJECTIVE
  Supracricoid laryngectomy with cricohyoidoepiglottopexy has been known to be able to cope with tumor excisions with minimal margins. Extended resection may result in a limited margin and may impair the prognosis. We conducted a clinicopathologic analysis of local recurrence in supracricoid laryngectomy with cricohyoidoepiglottopexy patients.
  
  
  METHODS
  Between 1997 and 2013, 100 patients with glottic cancers underwent supracricoid laryngectomy with cricohyoidoepiglottopexy. The clinicopathologic findings were evaluated. We also analyzed: (i) cancer-specific and overall survival rates, (ii) the correlation between locoregional recurrence and overall survival, (iii) T staging and larynx preservation rates and (iv) previous radiation history and larynx preservation rates.
  
  
  RESULTS
  Local recurrence was recognized in eight of the 100 patients (8%); all were initially staged as T3 or T4. Recurrence was identified in the submucosal regions of the ipsilateral arytenoid and/or infraglottis. Six patients were salvaged by completion total laryngectomy except two. Cancer-specific survival at 5 years was 93%; overall survival at 5 years was 89%. There was no significant difference between overall survival and locoregional recurrence. There was a significant difference between larynx preservation in T1-2 and T3-4 patients. There was no significant difference between larynx preservation and the previous radiation therapy status.
  
  
  CONCLUSIONS
  Our experience convinced us of the clinical potential of supracricoid laryngectomy with cricohyoidoepiglottopexy as one of the effective options for functional larynx preservation. Supracricoid laryngectomy with cricohyoidoepiglottopexy is the most suitable for unfavorable T2 and T3a cases and is applicable for appropriately selected radiation-failed patients. Thorough pre-operative evaluation, proper surgical techniques and careful follow-up are prerequisites for the success of supracricoid laryngectomy with cricohyoidoepiglottopexy.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa 252-0374, Japan meijin@med.kitasato-u.ac.jp.
authors.forename: Meijin
authors.initials: M
authors.lastname: Nakayama
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa 252-0374, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Miyamoto
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa 252-0374, Japan.
authors.forename: Yutomo
authors.initials: Y
authors.lastname: Seino
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa 252-0374, Japan.
authors.forename: Tabito
authors.initials: T
authors.lastname: Okamoto
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa 252-0374, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Kano
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa 252-0374, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hasebe
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa 252-0374, Japan.
authors.forename: Makito
authors.initials: M
authors.lastname: Okamoto
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D003413:Cricoid Cartilage; D005260:Female; D005602:France; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: functional larynx preservation; laryngeal cancer; local recurrence