Conservation surgery for radiation-failure carcinoma of the glottic larynx

A consecutive series of 28 patients treated by conservation surgery of the larynx for radiation-failure, recurrent rT1 and T2 (postradiotherapy staging) glottic squamous cell carcinoma treated at Memorial Sloan-Kettering Cancer Center from 1966 to 1983 is reviewed. The majority of patients were men with the age ranging from 46 to 76 years. The disease-free interval ranged from 0 to 113 months (median, 8.5 months). The stage at presentation was rT1 in 25 patients and rT2 in 3 patients. Surgery consisted of cordectomy (7 patients), hemilaryngectomy (18), and extended hemilaryngectomy (3). There was no operative mortality. Local recurrence developed in 8 patients (28.5%), cervical metastasis in 2, and distant metastasis in 1. Only 3 patients were salvaged by further treatment. The rate of local control was influenced by positive surgical margins. Overall, voice preservation was achieved in 75% of patients. The ultimate local control was 82.1% during a follow-up period that ranged from 1.3 to 16.7 years (median, 6.3 years). The actuarial survival at 5 and 10 years was 73% and 71% following conservation surgery of the larynx.