Supracricoid laryngectomy: a significant advance in the management of laryngeal cancer

Salvage with supracricoid partial laryngectomy after radiation failure

BACKGROUND

Supracricoid partial laryngectomy (SCPL) is an alternative to total laryngectomy (TL) for selected glottic and supraglottic carcinomas but its role in the setting of radiation failure is unclear. The aim of the present study was to present a series of patients with laryngeal cancer undergoing salvage surgery for local recurrence and examine the morbidity associated with this intervention.

METHODS

A retrospective review of 111 patients presenting with laryngeal cancer between 1997 and 2002 was performed. A total of 21 patients with recurrent disease following radiation therapy were identified, of which salvage surgery was performed in 18 patients. Minimum follow up of survivors was 22 months.

RESULTS

The 5-year cumulative local control and disease-specific survival was 76% and 85%, respectively. Surgical salvage consisted of TL in 12 patients and SCPL in six. The mortality and major morbidity rates for TL were 0% and 33%, and for SCPL they were 33% and 50%, respectively. Median length of hospital stay was similar in both groups (21 and 19 days). No patient undergoing SCPL developed recurrent disease at a median follow up of 19 months.

CONCLUSIONS

Supracricoid partial laryngectomy is an oncologically sound alternative to TL as salvage for radiation failure. The operative morbidity and potential for mortality is high in this setting.