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The Gregorio Marañón Hospital experience with vertical partial laryngectomies
B Scola1, M Fernández-Vega, T Martinez
1ENT Department, Gregorio Marañón Hospital, Madrid, Spain.
Summary
Conservative surgery for glottic carcinoma shows lower recurrence rates and better voice preservation than radiotherapy for early-stage disease. For advanced cases, partial laryngectomy offers better survival than radiotherapy with salvage laryngectomy.
Area of Science:
- Otolaryngology
- Oncology
- Surgical Oncology
Background:
- Glottic carcinoma treatment has evolved, with conservative surgical approaches gaining prominence.
- Comparing outcomes of different treatment modalities for glottic carcinoma is crucial for optimizing patient care.
Purpose of the Study:
- To evaluate the long-term outcomes of conservative surgery versus radiotherapy for glottic carcinoma.
- To compare tumor recurrence rates, voice preservation, and survival rates between treatment groups.
Main Methods:
- Retrospective study of 551 patients with glottic carcinoma treated between 1962 and 1996.
- Analysis of data based on tumor stage (early vs. locally advanced) and treatment modality (endoscopic laser resection, vertical hemilaryngectomy, radiotherapy, partial laryngectomy).
Main Results:
- For early-stage glottic carcinoma, no significant difference in 5-year survival between endoscopic laser resection, vertical hemilaryngectomy, and radiotherapy.
- Tumor recurrence was higher with primary radiotherapy (27%) than conservative surgery (12%), with better voice preservation in surgical groups (83% vs. 72%).
- Locally advanced cases treated with radiotherapy had a 50% recurrence rate; partial laryngectomy in selected patients yielded an 81% 5-year survival rate.
Conclusions:
- Conservative surgery offers superior tumor control and voice preservation for early-stage glottic carcinoma compared to radiotherapy.
- Partial laryngectomy is a viable and effective option for carefully selected patients with locally advanced glottic carcinoma, providing comparable survival to smaller lesions.