title: Salvage Transoral Laser Microsurgery for Radiorecurrent Laryngeal Cancer: Indications, Limits, and Outcomes.
abstract: OBJECTIVE
  The aim of this report is to identify relevant literature reports on salvage transoral laser microsurgery (TLM); to consider its oncologic and functional outcomes, as well as reported complications; and to address indications and limitations of salvage TLM.
  
  
  RESULTS
  The weighted average of local control after first salvage TLM was 57%. Repeated TLM procedures for second or third recurrences were required in up to 41% of cases, resulting in a weighted average of local control with TLM alone of 67%. The rate of definite laryngeal preservation was 73%. The ultimate local control rate, including cases that required total laryngectomy, was 90%. The overall complication rate after salvage TLM was 14%.
  
  
  CONCLUSIONS
  Salvage TLM of radiorecurrent laryngeal cancer yields excellent oncologic outcomes. Serious complications are scarce, hospitalization times are short, and functional outcomes in terms of voice and swallowing are favorable when compared to open conservation laryngeal surgery. The key to success is an optimal patient selection.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.|Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Meulemans
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Delaere
authors.affiliation: Department of Radiotherapy, University Hospitals Leuven, Leuven, Belgium.|Department of Oncology, Section Experimental Radiotherapy, KU Leuven, Leuven, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Nuyts
authors.affiliation: Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium.|Department of Medical Oncology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: P M
authors.initials: PM
authors.lastname: Clement
authors.affiliation: Department of Radiology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Hermans
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium.|Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium.
authors.forename: V
authors.initials: V
authors.lastname: Vander Poorten
keywords: Conservation surgery; Laryngeal cancer; Salvage surgery; Squamous cell carcinoma; Transoral laser microsurgery