Archives of otolaryngology--head & neck surgery · 2002
Partial laryngectomy to treat early glottic cancer after failure of radiation therapy.
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Toma Makiko, Nibu Ken-Ichi, Nakao Kazunari, Matsuzaki Masaki, Mochiki Masato, Yuge Tadashi, Terahara Atsuro, Sugasawa Masashi
Аннотация
OBJECTIVE: To evaluate the role of partial laryngectomy to treat glottic cancer after failure of radiation therapy.
DESIGN: A 12-year retrospective outcome analysis.
SETTING: University referral center.
PATIENTS: A total of 19 patients who underwent partial laryngectomy to treat glottic cancer after failure of radiation therapy.
RESULTS: The follow-up period in this group ranged from 31 to 144 months. After surgery, a laryngocutaneous fistula was observed in 4 cases, and flap necrosis occurred in 2, but these complications were successfully managed. Maximum phonation time after surgery ranged from 3 to 28 seconds (median phonation time, 10.2 seconds). Of these 19 patients, 3 developed local recurrence. These cases were successfully treated with total laryngectomy. A surgical margin of less than 1 mm was found to be a significant risk factor for local recurrence after partial laryngectomy.
CONCLUSIONS: These results indicate that partial laryngectomy is a useful option for the treatment of irradiation failure in the treatment of stage I and stage II vocal cord carcinomas. However, careful follow-up is mandatory for patients with a small surgical margin.
DESIGN: A 12-year retrospective outcome analysis.
SETTING: University referral center.
PATIENTS: A total of 19 patients who underwent partial laryngectomy to treat glottic cancer after failure of radiation therapy.
RESULTS: The follow-up period in this group ranged from 31 to 144 months. After surgery, a laryngocutaneous fistula was observed in 4 cases, and flap necrosis occurred in 2, but these complications were successfully managed. Maximum phonation time after surgery ranged from 3 to 28 seconds (median phonation time, 10.2 seconds). Of these 19 patients, 3 developed local recurrence. These cases were successfully treated with total laryngectomy. A surgical margin of less than 1 mm was found to be a significant risk factor for local recurrence after partial laryngectomy.
CONCLUSIONS: These results indicate that partial laryngectomy is a useful option for the treatment of irradiation failure in the treatment of stage I and stage II vocal cord carcinomas. However, careful follow-up is mandatory for patients with a small surgical margin.
Предметные рубрики MeSH
AdultAgedCarcinoma, Squamous CellFollow-Up StudiesGlottisHumansLaryngeal NeoplasmsLaryngectomyMaleMiddle AgedNeoplasm Recurrence, LocalOutcome and Process Assessment, Health CarePostoperative ComplicationsRecovery of FunctionRetrospective StudiesSalvage TherapySurvival RateTime FactorsTreatment Failure