[The relationship between the surgical margin and local recurrence of laryngeal carcinoma]

To study the relationship between the surgical margin and local recurrence of laryngeal carcinoma.

The surgical margin, T staging, postoperative irradiation and the local recurrence of 160 cases of laryngeal carcinoma operated between 1991 and 1999 were retrospectively reviewed and analyzed.

(1) Of 160 cases of laryngeal carcinoma, local recurrences were occurred in 36 cases (22.5%). (2) Local recurrence was statistically significantly related to the T staging of the tumor. (3) By comparing the local recurrence of 3 groups of patients: surgical margin < or = 3 mm, between 4-5 mm and > 5 mm, the rate of local recurrence of the group with surgical margin less than 3 mm were significantly higher than that of the groups with surgical margin between 4-5 mm and > 5 mm. (4) Of 69 cases with surgical margin less than 3 mm, 32 cases were received the postoperative irradiation, while 37 cases did not undergo. Statistical analysis showed that the local recurrence of the group of patients received postoperative irradiation was significantly lower than that of patients who did not received postoperative irradiation. (5) By analyzing the rate of local recurrence of difference surgical margin in the patients with glottic and supraglottic carcinoma, we found that the 5 mm as a surgical margin was relatively safe for the glottic carcinoma, but it was not the case for the supraglottic carcinoma.

5 mm as a surgical margin is relatively safe for the glottic carcinoma, but it is not the case for the supraglottic carcinoma. Therefore, the surgical margin more than 5 mm is proposed for supraglottic carcinoma. For the patients with surgical margin less than 3 mm, postoperative irradiation can effectively reduce the rate of local recurrence, but this does not mean that we can reduce the standard surgical margin during the laryngectomy.