Oncologic and functional outcomes of salvage supracricoid partial laryngectomy

Abstract

Background: Supracricoid partial laryngectomy (SCL) can have a positive impact on patients’ quality of life by circumventing dysphagia and voice problems resulting from creation of a permanent stoma after conventional total laryngectomy (TL) surgery.

Aims/Objectives: The aim of this study was to investigate the oncologic and functional outcomes of salvage SCL for recurrent laryngeal carcinoma.

Material and methods: Forty-five patients that underwent salvage surgery for recurrent laryngeal carcinoma between January 2004 and May 2015 after initial treatment failure were included in this retrospective study.

Results: Overall survival and disease free survival were non-significantly higher in the salvage SCL group (n = 14) than in the salvage TL group (n = 31) (87.5 versus 56.5%, 53.4 versus 41.9%). Multivariate analyses showed only positive resection margin to be significantly associated with survival and recurrence (HR 9.974, p = .007, and HR 9.196, p = .002, respectively). In the salvage SCL group, 92.8% achieved successful decannulation and all patients returned to an oral diet. All patients in the salvage TL group sustained a permanent stoma and conversation was possible only through esophageal voice or a voice prosthesis. 74.2% of patients in the group were able to tolerate an oral diet.

Conclusions and significance: Salvage SCL showed comparable oncologic outcomes and favorable functional outcomes relative to the classic salvage TL. This study could provide a sufficient basis of SCL as salvage treatment for recurrent laryngeal carcinoma in selected patients.

Chinese abstract

背景：超常喉部分喉切除术（SCL）可以克服常规全喉切除术（TL）手术后产生永久性造口而引起的吞咽困难和声音问题, 对患者的生活质量产生积极影响。

目的：本研究的目的是调查挽救性SCL治疗复发性喉癌的肿瘤学的和功能上的结果。

材料和方法：本回顾性研究纳入了45例在初始治疗失败后于2004年1月至2015年5月接受复发性喉癌挽救性手术的患者。

结果：挽救性SCL组（n = 14）的总生存期和无病生存率均非显著高于挽救性TL组（n = 31）（87.5% 对56.5％；53.4% 对41.9％）。多变量分析显示只有正切除边缘与生存和复发显著相关（HR 9.974, p = .007；HR 9.196, p = .002）。在挽救性SCL组中, 92.8％成功拔管, 所有患者均恢复口服饮食。挽救性TL组中的所有患者都保有永久性造口并且仅通过食道声音或人造声音体进行对话。该组中74.2％的患者能够勉强接受口服饮食。

结论和意义：与经典挽救性TL相比, 挽救性SCL显示出相当的肿瘤学结果和有利的功能结果。本研究可为SCL作为所选患者复发性喉癌的挽救性治疗方法, 提供足够的基础。

Keywords:

• Recurrent laryngeal carcinoma
• salvage surgery
• supracricoid partial laryngectomy
• total laryngectomy

Disclosure statement

No potential conflict of interest was reported by the authors.