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Partial laryngectomy after irradiation failure.

R D Nichols1, S A Mickelson

  • 1Department of Otolaryngology, Henry Ford Hospital, Detroit, Michigan 48202.

The Annals of Otology, Rhinology, and Laryngology
|March 1, 1991
PubMed
Summary
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Partial laryngectomies after radiotherapy failure for laryngeal carcinoma offer good cure rates. However, 28% needed further surgery, and positive margins require immediate intervention.

Area of Science:

  • Otolaryngology
  • Head and Neck Surgery
  • Oncology

Background:

  • Laryngeal carcinoma treatment often involves radiotherapy.
  • Salvage surgery, including partial laryngectomy, is considered after radiotherapy failure.
  • Assessing outcomes of partial laryngectomy post-radiotherapy is crucial.

Purpose of the Study:

  • To evaluate the outcomes of partial laryngectomies performed after radiotherapy failure in patients with laryngeal carcinoma.
  • To determine complication rates and survival data for these procedures.

Main Methods:

  • Retrospective review of 43 patients undergoing partial laryngectomy after failed radiotherapy for laryngeal cancer.
  • Analysis of surgical procedures (supraglottic, endoscopic, vertical partial), complications, margin status, and survival rates.

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Main Results:

  • Twelve patients (28%) required completion laryngectomy.
  • Major complications included stenosis, sphincter incompetence, fistulas, and deglutition issues.
  • All patients with positive permanent margins had recurrent disease; 5 had negative frozen sections.
  • Disease-free survival rates were 85% for Stage I/II and 50% for Stage III/IV at 2-3 years.

Conclusions:

  • Partial laryngectomies, including supraglottic procedures, are viable salvage options after radiotherapy failure for laryngeal carcinoma.
  • These procedures offer a high expectation of cure with acceptable morbidity.
  • Immediate completion surgery is recommended for positive margins identified on permanent sections.