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Oncologic and functional outcomes of salvage supracricoid partial laryngectomy

 Ji Hoon Kim  ;  Won Shik Kim  ;  Yoon Woo Koh  ;  Se-Heon Kim  ;  Hyung Kwon Byeon  ;  Eun Chang Choi 
 Acta Oto-Laryngologica, Vol.138(12) : 1117-1122, 2018 
Journal Title
 Acta Oto-Laryngologica 
Issue Date
Adult ; Aged ; Cancer Care Facilities ; Carcinoma, Squamous Cell/mortality* ; Carcinoma, Squamous Cell/pathology ; Carcinoma, Squamous Cell/surgery* ; China ; Cohort Studies ; Cricoid Cartilage/surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Laryngeal Neoplasms/mortality* ; Laryngeal Neoplasms/pathology ; Laryngeal Neoplasms/surgery* ; Laryngectomy/methods* ; Laryngectomy/mortality ; Male ; Middle Aged ; Neoplasm Invasiveness/pathology ; Neoplasm Staging ; Proportional Hazards Models ; Quality of Life ; Retrospective Studies ; Salvage Therapy ; Survival Analysis
Recurrent laryngeal carcinoma ; salvage surgery ; supracricoid partial laryngectomy ; total laryngectomy
BACKGROUND: Supracricoid partial laryngectomy (SCL) can have a positive impact on patients' quality of life by circumventing dysphagia and voice problems resulting from creation of a permanent stoma after conventional total laryngectomy (TL) surgery. AIMS/OBJECTIVES: The aim of this study was to investigate the oncologic and functional outcomes of salvage SCL for recurrent laryngeal carcinoma. MATERIAL AND METHODS: Forty-five patients that underwent salvage surgery for recurrent laryngeal carcinoma between January 2004 and May 2015 after initial treatment failure were included in this retrospective study. RESULTS: Overall survival and disease free survival were non-significantly higher in the salvage SCL group (n = 14) than in the salvage TL group (n = 31) (87.5 versus 56.5%, 53.4 versus 41.9%). Multivariate analyses showed only positive resection margin to be significantly associated with survival and recurrence (HR 9.974, p = .007, and HR 9.196, p = .002, respectively). In the salvage SCL group, 92.8% achieved successful decannulation and all patients returned to an oral diet. All patients in the salvage TL group sustained a permanent stoma and conversation was possible only through esophageal voice or a voice prosthesis. 74.2% of patients in the group were able to tolerate an oral diet. CONCLUSIONS AND SIGNIFICANCE: Salvage SCL showed comparable oncologic outcomes and favorable functional outcomes relative to the classic salvage TL. This study could provide a sufficient basis of SCL as salvage treatment for recurrent laryngeal carcinoma in selected patients.
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1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Koh, Yoon Woo(고윤우)
Choi, Eun Chang(최은창)
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