[Oncological failure after partial laryngectomy for laryngeal carcinoma]

The aim of the study was an evaluation of oncological failures after partial laryngectomies for treatment of laryngeal carcinoma. A retrospective analysis was done on 325 partial laryngectomies performed during 18 years (1980-1997) at Otolaryngology Department Medical University of Lódź. Seventy four failures (22.8%) were observed, among them local recurrences--in 43 patients (13.2%), nodal recurrences--in 9 patients (2.8%), distant metastases--in 6 patients (1.8%), second primary malignant neoplasms--in 11 patients (3.4%) and spread of neoplastic disease--in 8 patients (2.5%). Local recurrence was statistically the most often type of failure--58.1% in comparison with frequency of the others (p<0.001). The failures, according to type of partial laryngectomy, occurred rarely after cordectomy--17.5%, the most frequently were noted after supraglottic horizontal laryngectomy--42.3% (p<0.01) and fronto-lateral/fronto-anterior laryngectomy--30.9% (p<0.05). Majority of failures were diagnosed within first 2 years after primary treatment--55.4% of all failures in comparison with third (12.2%), fourth and fifth years (5.4%), but they were also often observed over 5 years (27%) (p<0.05). A statistical difference in percentage of failures in the periods until 5 years and over 5 years was noted only for cordectomy (23.8% and 4.9% respectively, p<0.001) and supraglottic laryngectomy (56.3% and 12.5% respectively, p<0.05). Systematic control of patients after partial laryngectomies is necessary all over their life.