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Early glottic carcinoma treated with open laryngeal procedures
J V Thomas1, K D Olsen, H B Neel
1Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minn.
Objective:
The purpose of this study was to determine the recurrence rate and long-term survival of patients treated with open cervical procedures.
Design:
The study is a retrospective analysis of a cohort of patients who underwent an open laryngeal procedure between 1976 and 1986. The median follow-up was 6.6 years.
Patients/Participants:
The sample was a consecutive series of 159 patients with early glottic carcinoma without impaired vocal cord mobility. Patients with a history of radiation therapy or surgical treatment elsewhere were excluded.
Intervention:
Surgical treatment in this group of 159 patients included 82 frontolateral partial vertical laryngectomies, 61 laryngofissures with cordectomy, 12 hemilaryngectomies, and four anterior commissure procedures.
Outcome Measure:
Estimates of survival time beyond the day of surgery, time to first recurrence (local, regional, and distant), and time to first local recurrence were obtained with the Kaplan-Meier product-limit method.
Results:
Eleven patients experienced recurrent laryngeal cancer. Ten patients underwent laryngectomy for recurrence. One patient underwent an anterior commissure procedure. Three of the 11 patients who underwent re-treatment of the larynx were ultimately salvaged. The probability of survival at 3 and 5 years was 91% and 84%, respectively. The probability of remaining free of local recurrence 3 and 5 years after surgery was 94% and 93%, respectively.
Conclusion:
In our experience, open laryngeal procedures continue to be excellent treatment for select cases of early glottic carcinoma. They are versatile and efficacious for managing the wide spectrum of larger T1 glottic carcinomas.
