[Preservation surgery of head and neck cancer. Results and postsurgical function]

The purpose of conservation surgery is to eradicate the cancerous lesion while preserving the morphology and function of the affected organ as much as possible. Many important functions including swallowing, phonation and articulation are carried out by the organs in the head and neck. This paper presents the short-term (2 years) results of conservation surgery for carcinomas of the tongue, oropharynx, hypopharynx and larynx. Long-term results await further follow-up because of the fact that we started full use of conservation surgery rather recently. Three types of conservation surgery were applied for cancer of the tongue in 36 cases:laser surgery alone, laser debulking surgery followed by (chemo) radiotherapy and induction chemotherapy followed by laser debulking surgery and radiotherapy. The local control rate and survival rate were 97% and 88%, respectively. The basic principles of conservation surgery for oropharyngeal cancer were the same as those for cancer of the tongue. A total of 23 patients were treated, yielding a 65% local control rate and a 63% survival rate. For hypopharyngeal cancer, two types of conservation surgery were applied:partial pharyngectomy and partial laryngopharyngectomy. A total of 10 patients underwent these procedures. The local control rate was 60% and the survival rate was 70%. Two major groups of conservation surgery were applied for cancer of the larynx:laser surgery with or without radiotherapy in 74 cases and partial laryngectomy in 94 cases. The local control rate was 69% for laser surgery and 87% for partial laryngectomy, while the survival rates were 100% and 91%, respectively.