title: [Laryngeal conservative surgery in patients candidates for combined treatment with chemo-radiotherapy].
abstract: BACKGROUND
  The standard of care for advanced-stage laryngeal cancer is combined treatment (chemo-radiotherapy). However, the complications with this treatment are not few, mainly in swallowing. Conservative laryngeal surgery remains an effective alternative for cancer control without the complications of chemo-radiotherapy.
  
  
  METHODS
  Retrospective study was conducted on patients with laryngeal cancer cT3, cN0 with paraglottic infiltration, fixation of the vocal cord, minimal invasion of the hyo-thyroepiglottic space, but with normal arytenoid mobility and no sub-glottic extension, were treated with subtotal supracricoid laryngectomy. Complications, sequels of treatment, and local recurrence were evaluated. Bronchial aspiration was studied with radioactive swallow.
  
  
  RESULTS
  There were 25 patients, 22 with negative surgical margins, one had tumour contact with the surgical margins, and 2 were positive. Two patients received postoperative radiotherapy. The mean decannulation was 15 days and removal of nasogastric tube 25 days. During the mean follow-up of 26 months, none of the patients had tumour recurrence or required conversion to total laryngectomy. In all patients swallowing has been normal and none required permanent or temporary tracheotomy or definitive gastrostomy. The voice is considered intelligible in all patients. Radioactive swallow showed aspiration in 15/25 patients, with none being clinically relevant. There were postoperative complications in 5 patients, and 4 patients required re-intervention but no conversion to total laryngectomy.
  
  
  CONCLUSIONS
  Conservative surgery is an effective surgical-alternative to chemo-radiotherapy in patients with locally advanced laryngeal cancer, providing oncological control, acceptable complications and minimal sequels. Although most patients have aspiration, this does not affect functional status.
authors.affiliation: Departamento de Tumores de Cabeza y Cuello, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México. Electronic address: gal61@prodigy.net.mx.
authors.forename: José Francisco
authors.initials: JF
authors.lastname: Gallegos-Hernández
authors.affiliation: Departamento de Tumores de Cabeza y Cuello, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.
authors.forename: Iván
authors.initials: I
authors.lastname: Cruz-Esquivel
authors.affiliation: Departamento de Tumores de Cabeza y Cuello, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.
authors.forename: Alma Lilia
authors.initials: AL
authors.lastname: Ortiz-Maldonado
authors.affiliation: Departamento de Tumores de Cabeza y Cuello, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.
authors.forename: Gerardo Gabriel
authors.initials: GG
authors.lastname: Minauro-Muñoz
authors.affiliation: Departamento de Tumores de Cabeza y Cuello, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.
authors.forename: Héctor
authors.initials: H
authors.lastname: Arias-Ceballos
authors.affiliation: Departamento de Medicina Nuclear, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México.
authors.forename: Pablo
authors.initials: P
authors.lastname: Pichardo-Romero
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments; D012189:Retrospective Studies
keywords: Cirugía conservadora; Conservative laryngectomy; Conservative surgery; Cáncer de laringe; Laringectomía conservadora; Laringectomía parcial; Laryngeal cancer; Partial laryngectomy