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Twenty-year experience with salvage total laryngectomy: lessons learned.
N Tsetsos1, A Poutoglidis1, K Vlachtsis1
1Department of Otorhinolaryngology - Head and Neck Surgery, 'G. Papanikolaou' General Hospital, Thessaloniki, Greece.
The Journal of Laryngology and Otology
|July 5, 2021
Summary
Salvage total laryngectomy offers limited long-term survival, with over half of patients not surviving five years. Regional recurrence is a primary cause of failure, suggesting improved neck dissection strategies for advanced recurrences.
Area of Science:
- Otolaryngology
- Surgical Oncology
- Head and Neck Cancer Research
Background:
- Salvage total laryngectomy is a treatment option for recurrent laryngeal cancer.
- Understanding outcomes is crucial for optimizing patient care and surgical planning.
Purpose of the Study:
- To evaluate the outcomes of salvage total laryngectomy.
- To identify areas for improvement in managing recurrent laryngeal cancer.
Main Methods:
- Retrospective analysis of patients undergoing salvage total laryngectomy.
- Data collected from January 1999 to December 2018.
Main Results:
- Thirty-one patients were analyzed, with glottic cancer being the most common primary site (83.8%).
- Overall survival at 5 years was 45%, and disease-free survival was 42%.
- Pharyngocutaneous fistula occurred in 29% of cases.
Conclusions:
- Long-term survival after salvage total laryngectomy is poor, with over 50% mortality within five years.
- Regional recurrence is the predominant cause of treatment failure and death.
- Elective neck dissection is recommended for early laryngeal cancer with advanced recurrence.
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