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Supraglottic laryngectomy: functional and oncologic results

J Herranz-González1, J Gavilán, J Martínez-Vidal

  • 1Department of Otorhinolaryngology, Juan Canalejo Hospital, La Coruña, Spain.

The Annals of Otology, Rhinology, and Laryngology
|January 1, 1996
PubMed
Summary

This study on supraglottic cancer treatment found that while T stage didn't affect survival, N stage significantly impacted outcomes. Most patients achieved decannulation after supraglottic laryngectomy and neck dissection.

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Area of Science:

  • Otolaryngology
  • Surgical Oncology
  • Radiation Oncology

Background:

  • Squamous cell carcinoma of the supraglottis presents a significant challenge in head and neck oncology.
  • Treatment often involves a multimodal approach including surgery and radiotherapy.

Purpose of the Study:

  • To evaluate the outcomes of supraglottic laryngectomy and neck dissection in patients with squamous cell carcinoma of the supraglottis.
  • To assess the impact of tumor stage (T and N) on survival and disease control.

Main Methods:

  • Retrospective analysis of 110 patients treated between 1980 and 1989.
  • Supraglottic laryngectomy and neck dissection as primary surgical treatment.
  • Adjuvant radiotherapy administered to pN+ cases (5,000-6,500 cGy).

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  • Follow-up until death or minimum 36 months (average 65 months).

    • Main Results:

    • Stage distribution: I (23%), II (34%), III (15%), IV (28%).
    • High decannulation rate (96%); one patient required total laryngectomy due to aspiration.
    • Overall 3-year survival: 78%. Local control: 94.6%; regional control: 83.6%.
    • Survival significantly influenced by N stage, but not T stage.

    Conclusions:

    • Supraglottic laryngectomy and neck dissection provide effective local and regional control for supraglottic squamous cell carcinoma.
    • Nodal status is a critical prognostic factor for survival in these patients.
    • Adjuvant radiotherapy in pN+ cases requires careful management to mitigate side effects like arytenoid edema, which can delay decannulation.