[Radical surgery of the malignant laryngeal tumors]

Modern therapeutical protocols for treatment of T3 and T4 malignomas of the larynx are not adjusted, because there are attempts to treat these diseases with non-operative methods (such as chemo- and radiotherapy) in order to preserve the organ. The aim of the study was to establish today's results of the surgical treatement of patients with T3 and T4 laryngeal malignoma. We studied the group of patients with laryngeal carcinoma, who had undergone total laryngectomy, during the period of eight years (1990-1997). The patients' data was submitted from medical documentation, it was filled in specially designed questionnaries and was statistically reviewed. During this eight-year-period, 1054 total laryngectomies were done. The five-years survival rate, established in the group of patients who had undergone total laryngectomiy is 308/794 (39%). In the patient group where total laryngectomy was salvage surgery after radiotherapy, the five-years survival rate is 47/172 (27%). In the patient group where total laryngectomy was salvage surgery after conservative or reconstructive surgery, the five-years survival rate is 28/84 (33%). Despite diagnostical and therapeutical achievements, prognosis for T3 and T4 malygnoma of the larynx was not significantly approved in the last few decades.