[Oncologic surgery of the larynx after failure of radiotherapy]

The treatment of early-stage laryngeal cancer using either partial surgical techniques or irradiation still is controversial. The performance of rescue surgical procedures after irradiation is related to increased postsurgical complications and lower survival rates. We made a retrospective study of 73 patients who underwent rescue surgery after failure of radiotherapy in our department in the last 10 years. A statistical analysis was made of the complications and survival rate of these patients in accordance with tumor location and clinicopathological stage compared with patients who underwent surgery alone (n = 435). More rescue surgery was performed for glottic carcinomas (52/73) than for supraglottic carcinomas (21/73). No significant differences were found in the complication rate (23.6%) compared with the control group (19.6%). There was a significant reduction in survival in patients who underwent previous irradiation of supraglottic tumors compared with glottic tumors and the control group. In view of these results, we conclude that irradiation is not a good option as an initial treatment for supraglottic tumors and that the procedure of choice should be surgical.