Supraglottic laryngectomy: series report and analysis of results

Forty-one consecutive patients who underwent supraglottic laryngectomy at UCLA were reviewed. All of the operations were performed by or under the direct supervision of the same surgeon (T.C.). The majority (68%) had advanced squamous cell carcinoma (Stage III-IV). Approximately one half received radiation therapy as part of planned combined therapy. The overall tumor-free survival, with a two-year minimum follow-up period, was 90%. The most common site of tumor recurrence was neck metastasis. There were four laryngeal recurrences, three of which were salvaged with completion laryngectomy. There was only one completion laryngectomy for severe aspiration. The favorable results in this series are attributed to frozen section control of surgical margins, surgical or radiation therapy treatment of cervical lymph nodes at risk for metastatic disease, and the employment of surgical techniques designed to minimize aspiration.