Stomal recurrence. A critical analysis of risk factors.

Stomal recurrence developed in 5% of the 507 patients who underwent total laryngectomy for a squamous cell carcinoma. The most common site of the primary tumor was the glottis, followed by the supraglottic and pyriform sinus regions. Initial subglottic extension of the tumor and metastatic lymphadenopathy were the most significant risk factors. The primary tumor size, prior emergency tracheostomy, and conservation surgical procedures had no effect on the incidence of stomal recurrence. The median survival in patients with stomal malignant neoplasms was only five months. In high-risk patients, extended dissection or elective postoperative radiotherapy is recommended.