title: Open partial horizontal laryngectomy for salvage after failure of CO₂ laser-assisted surgery for glottic carcinoma.
abstract: Total laryngectomy (TL) is often still recommended as a salvage approach for recurrent laryngeal squamous cell carcinoma (LSCC). Considering LSCC recurrences after the failure of primary transoral laser microsurgery (TLM), open partial horizontal laryngectomy (OPHL) could be a valid alternative to TL in selected patients. The aim of the present study was to analyze retrospectively the oncological outcome of a consecutive series of 17 patients treated at the Otolaryngology Unit of Vittorio Veneto Hospital (Italy) with OPHL after primary TLM had failed. Nine patients (53 %) had no further recurrences after salvage OPHL. Eight patients had a second recurrence of LSCC after OPHL, and five of them were cured by further salvage treatment, while the other three died of their disease. We found an overall and disease-specific survival both of 82 % and a loco-regional control rate and an ultimate organ preservation rate of 82 and 70 %, respectively. Patients who underwent two-stage bilateral cordectomy for primary glottic carcinoma showed a trend towards a higher rate of second recurrences, a lower ultimate organ preservation rate and a shorter disease-free survival after salvage OPHL. Further studies on larger cohorts of patients are needed to identify potential clinical and/or pathological prognostic parameters capable of pinpointing patients at higher risk of second recurrences after salvage OPHL in cases where TLM has failed. A salvage TL might be reasonably proposed as a first salvage choice in such cases.
authors: Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Italy.
authors: Marco
authors: M
authors: Lucioni
authors: Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Italy.
authors: Andy
authors: A
authors: Bertolin
authors: Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Italy. marcolionello@email.it.|Otolaryngology Section, Department of Neurosciences DNS, University of Padova, Via Giustiniani 2, 35128, Padova, Italy. marcolionello@email.it.
authors: Marco
authors: M
authors: Lionello
authors: Department of Medicine DIMED, University of Padova, Padova, Italy.
authors: Luciano
authors: L
authors: Giacomelli
authors: Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Italy.
authors: Giuseppe
authors: G
authors: Rizzotto
authors: Otolaryngology Section, Department of Neurosciences DNS, University of Padova, Via Giustiniani 2, 35128, Padova, Italy.
authors: Gino
authors: G
authors: Marioni
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005931:Glottis / Q000473:pathology / Q000601:surgery; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery; D007825:Laryngectomy / Q000379:methods*; D053685:Laser Therapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D054020:Lasers, Gas; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*
keywords: Glottic carcinoma; Laser; Partial laryngectomy; Prognosis; Salvage