The oncologic safety and functional preservation of supraglottic partial laryngectomy

The purpose of this study was to evaluate the appropriateness of the conservative surgery as the initial treatment of supraglottic cancer by the comparative study of supraglottic partial laryngectomy with radiation therapy.

We analyzed 48 patients diagnosed as having supraglottic cancer who underwent supraglottic partial laryngectomy and 20 patients treated with radiation therapy as initial treatment from 1991 to 2005. Oncologic safety was evaluated by comparison of survival rates. Swallowing test was performed with videoesophagofluoroscopy under the category of the pharyngeal phase and the presence or absence of aspiration. Phonologic analysis was performed with acoustic waveform analysis and stroboscopy.

Positive resection margin was observed in 12 of the patients who received supraglottic partial laryngectomy (SPL), and its relationship with the primary subsite was evaluated. For the patients in stages I and II, the overall survival rate in each of the SPL group and the radiotherapy (RTx) group was 87% and 80%, respectively. For the patients in stages III and IV, the overall survival rate was 87% and 80%, respectively. On evaluation of swallowing and phonation function, no significant difference was noted between the SPL group and the RTx group.

This study suggests that for patients with supraglottic cancer, SPL provides acceptable survival, swallowing, and phonologic results in comparison with radiation therapy.