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Published on: March 18, 2020
Salvage laryngectomy: oncological and functional outcome
L van der Putten1, R de Bree, D J Kuik
1Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, P.O. Box 7057, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Oral Oncology
|March 2, 2011
Summary
Salvage laryngectomy after radiotherapy offers 58% survival but carries a 56% complication rate. Functional outcomes, including speech and diet, were generally good for patients with laryngeal cancer.
Area of Science:
- Otolaryngology
- Head and Neck Surgery
- Oncology
Background:
- Salvage laryngectomy is a treatment option for persistent or recurrent laryngeal cancer after radiotherapy.
- Neck management is a critical component of salvage laryngectomy for head and neck cancer patients.
Purpose of the Study:
- To evaluate postoperative complications, functional outcomes, and survival rates following salvage laryngectomy for laryngeal cancer.
- To assess the effectiveness of neck management strategies in conjunction with salvage laryngectomy.
Main Methods:
- Retrospective analysis of 120 patients undergoing total laryngectomy for residual or recurrent squamous cell laryngeal carcinoma post-(chemo)radiotherapy (November 1990 - June 2007).
- Evaluation of complication rates, including major and minor complications.
- Analysis of neck dissection findings, including lymph node metastasis.
- Assessment of disease-specific survival, functional outcomes (speech, diet), and body mass index changes.
Main Results:
- A 56% overall complication rate (33% major, 23% minor) was observed.
- Lymph node metastases were present in 26% of neck dissections.
- Five-year disease-specific survival was 58%.
- Positive surgical margins were the only significant independent predictor of worse survival in multivariate analysis (p<0.001).
- Speech restoration with a voice prosthesis was achieved in 87% of patients.
- 84% of patients could tolerate a normal or soft diet post-surgery.
Conclusions:
- Salvage laryngectomy following radiotherapy provides good survival rates for laryngeal cancer patients.
- Patients face a substantial risk of postoperative complications.
- Functional outcomes regarding speech and diet are generally favorable.
- Careful surgical technique, particularly achieving negative margins, is crucial for optimizing survival outcomes.
