Outcome of conservation surgery for laryngeal carcinoma: an 8-year trial

The purpose of this report is to review the experience of our institution with conservative surgery for laryngeal cancer. In this retrospective study, a review was made of 85 patients treated with conservation surgery between 1998 and 2005. At least 2 years of follow-up period (mean 46.6 months) was achieved for all the patients. We evaluated age, tobacco and alcohol intake, T stage, histopathological differentiation and localization of tumor, subglottic extension, anterior commissure invasion, vocal cord mobility, surgical margins, type of surgery applied, and post-operative radiotherapy (pRT) applied. Local control and 2-year survival rates were estimated. We managed with horizontal, vertical, and horizontovertical laryngectomies in 55, 26, and 4 patients, respectively. 28 patients were scheduled to have pRT. The actuarial and overall local control rates were 82.4 and 94.1%, respectively. On univariable analysis, significant factors for increased recurrences were positive resection margins, low differentiation of tumor, alcohol consumption and incompletion of the planned pRT. The 2-year survival rate was 60 and 95.7% for patients with and without local recurrence, respectively. Conservation surgery is a safe procedure for laryngeal cancer in proper endications.