Prognostic importance of the tumor-free laryngectomy specimen.

In a review of 500 consecutive laryngectomies, 36 specimens were found with no tumor. All patients had received radiation treatment preoperatively. Patients with small primary tumors and no tumor evident in microscopically examined lymph nodes had excellent long-term survival. Those patients with extensive (T4) primary tumors or with tumor found microscopically in their lymph nodes had poor survival statistics. This information reconfirms the known limitations of radiation and surgery in the case of the patient with advanced head and neck cancer. Hopefully, adjuvant chemotherapy or immunotherapy will improve the survival of these patients.