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Partial laryngectomy after radiation failure

R D Nichols, P H Stine, K J Greenawald

    The Laryngoscope
    |April 1, 1980
    PubMed
    Summary
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    Radiation therapy fails for 15-32% of laryngeal cancer patients. Partial laryngectomy offers a viable salvage option for recurrent tumors, achieving local control in many cases with a comparable prognosis to total laryngectomy.

    Area of Science:

    • Oncology
    • Otolaryngology
    • Surgical Oncology

    Background:

    • Radiation therapy is a primary treatment for limited laryngeal carcinoma.
    • A significant percentage of patients (15-32%) experience treatment failure with radiation alone.
    • Recurrent or persistent laryngeal cancer after radiation requires alternative management strategies.

    Purpose of the Study:

    • To review the efficacy of partial laryngectomy as a salvage procedure for laryngeal carcinoma after radiation failure.
    • To report the institutional experience with partial laryngectomy in patients with recurrent or persistent disease post-radiation.

    Main Methods:

    • Retrospective review of 18 patients who underwent partial laryngectomy.
    • Patients had received full-dose radiation therapy prior to surgery for laryngeal carcinoma.

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  • Surgical goal was to control recurrent or persistent disease at the primary tumor site.

    • Main Results:

    • Four patients achieved biopsy-proven cures following partial laryngectomy.
    • Local tumor control was successful in 10 out of 14 evaluable patients.
    • Three of four partial failures were subsequently salvaged with total laryngectomy; major wound complications occurred in 4 patients, with prolonged healing observed in most.

    Conclusions:

    • Partial laryngectomy is a feasible surgical option for managing laryngeal cancer recurrence after radiation failure.
    • The procedure can achieve local tumor control and offers a prognosis potentially similar to total laryngectomy.
    • Careful patient selection and surgical expertise are crucial, considering potential wound complications and prolonged healing.