title: Prognostic factors for survival after salvage total laryngectomy following radiotherapy or chemoradiation failure: a 10-year retrospective longitudinal study in eastern Denmark.
abstract: OBJECTIVE
  The primary aims were to determine the rates of and prognostic factors for overall survival, disease-specific survival and disease-free survival following salvage total laryngectomy.
  
  
  METHODS
  Retrospective longitudinal study.
  
  
  METHODS
  Tertiary medical centres.
  
  
  METHODS
  A total of 142 patients in eastern Denmark undergoing salvage total laryngectomy for squamous cell carcinoma of the larynx or hypopharynx.
  
  
  METHODS
  5-year overall survival, 5-year disease-specific survival, 5-year disease-free survival and prognostic factors for these outcomes.
  
  
  RESULTS
  5-year overall survival, disease-specific survival and disease-free survival were 37.7%, 54.9% and 55.3%, respectively. N classification at primary diagnosis, lymph node excision and postoperative complications within 1 year after salvage total laryngectomy were prognostic factors for shorter overall survival, disease-specific survival and disease-free survival. Residual tumour/recurrence was negatively associated with overall survival, close or involved resection margins with disease-specific survival, and second primary cancer was associated with longer disease-specific survival and disease-free survival. Nine per cent of all patients had residual tumour and 33.8% developed a recurrence.
  
  
  CONCLUSIONS
  Our overall survival, disease-specific survival and disease-free survival findings are in accordance with previous studies. With the purpose of identifying recurrent tumour, we suggest extra attention being given to patients with higher N classification and need for lymph node excision during salvage total laryngectomy along with use of frozen sections. The high number of patients with recurrence within 1 year after salvage total laryngectomy occurred although thorough and regular follow-up visits were performed.
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen.
authors.forename: N B
authors.initials: NB
authors.lastname: Wulff
authors.affiliation: Department of Oncology, Herlev Hospital, University Hospital of Copenhagen, Herlev.
authors.forename: E
authors.initials: E
authors.lastname: Andersen
authors.affiliation: Department of Oncology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen.
authors.forename: C A
authors.initials: CA
authors.lastname: Kristensen
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen.
authors.forename: C H
authors.initials: CH
authors.lastname: Sørensen
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen.
authors.forename: B
authors.initials: B
authors.lastname: Charabi
authors.affiliation: Department of Otolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen.|Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge.
authors.forename: P
authors.initials: P
authors.lastname: Homøe
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery* / Q000628:therapy; D059248:Chemoradiotherapy; D003718:Denmark; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery* / Q000628:therapy; D007825:Laryngectomy / Q000379:methods*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016879:Salvage Therapy; D015996:Survival Rate; D017211:Treatment Failure