Salvage Partial Laryngectomy after Failed Radiotherapy: Oncological and Functional Outcomes

To investigate oncological and functional outcomes in patients treated with salvage partial laryngectomy (SPL) after failed radio/chemotherapy.

Retrospective multicenter chart review.

Medical records of patients treated with SPL from January 1998 to January 2018 in two University Medical centers were retrieved. The SPL included horizontal supraglottic laryngectomy, hemi-laryngectomy and crico-hyoido-epiglottopexy. The following outcomes were investigated: histopathological features; overall survival (OS); recurrence-free survival (RFS) local and regional controls; post-operative speech recovery; and the oral diet restart and decannulation.

The data of 20 patients with cT1-cT3 laryngeal cancer were collected. The mean follow-up of patients was 69.7 months. The mean hospital stay was 43.0 days (16-111). The following complications occurred in the immediate post-operative follow-up: neck fistula (N = 6), aspiration pneumonia (N = 5), and chondronecrosis (N = 2). Early or late total laryngectomy was carried out over the follow-up period for the following reasons: positive margins and local recurrence/progression (N = 7), chondronecrosis (N = 2) and non-functional larynx (N = 1). The restart of the oral diet was carried out in 12/15 (80%) SPL patients (five patients being excluded for totalization). All patients recovered speech, and decannulation was performed in 14 patients (93%). The 5-year OS and RFS were 50% and 56%, respectively. The 5-year local and regional control rates were 56% and 56%, respectively.

Partial laryngectomy is an alternative therapeutic approach to total laryngectomy in patients with a history of failed radiation.