Clinical Analysis of 74 Cases of Laryngeal Cancer who Underwent Frontolateral Partial Vertical Laryngectomy-Usefulness of Salvage Surgery after Failure of a Full Course of Radiotherapy-

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  • Miura Kouki
    Department of Head and Neck Oncology and Surgery, International University of Health and Welfare
  • Kamata Shin-etsu
    Department of Head and Neck Oncology and Surgery, International University of Health and Welfare
  • Kawabata Kazuyoshi
    Division of Head and Neck, The Cancer Institute Hospital
  • Tada Yuuichirou
    Department of Head and Neck Oncology and Surgery, International University of Health and Welfare
  • Masubuti Tatuo
    Department of Head and Neck Oncology and Surgery, International University of Health and Welfare
  • Nakamura Narihiro
    Department of Head and Neck Oncology and Surgery, International University of Health and Welfare

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Other Title
  • 前側方喉頭垂直部分切除術を施行した喉頭癌７４例の臨床的検討―根治照射後救済手術としての有用性―
  • ゼンソクホウ コウトウ スイチョク ブブン セツジョジュツ オ シコウシタ コウトウ ガン 74レイ ノ リンショウテキ ケントウ コンチ ショウシャゴ キュウサイ シュジュツ ト シテノ ユウヨウセイ
  • —Usefulness of Salvage Surgery after Failure of a Full Course of Radiotherapy—
  • ―根治照射後救済手術としての有用性―

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Abstract

This study was designed to analyze the surgical (postoperative course, mortality, morbidity), oncological (local control, survival rate) and functional (maximum phonation time : MPT) results of frontolateral partial vertical laryngectomy (FLPVL), in order to evaluate the advantages and disadvantages of salvage FLPVL after a full course of radiotherapy (FRT). A retrospective analysis of the results in the 74 patients (of whom 61 had previously received FRT) was undertaken. The median follow up was 68 months (range 12-290 months). No significant influence of the prior FRT was noted on the deglutition, respiration, or duration of hospitalization. The frequency of complications after discharge, but not of that during hospitalization was significantly higher in the prior FRT group. Speech (MPT) was significantly shorter (poor effect) in the prior FRT group with standard extirpation. Recurrence developed in 8 patients : in the larynx only in 7 cases, and in both the larynx and neck in the remaining one case. One patient with control of the primary showed relapse in the neck and lung. Subsequent surgery was successful in salvaging 5 of the 8 cases with local failure. One died refusing TL, and two because of uncontrolled neck recurrence. Hence, the overall laryngeal preservation rate following salvage FLPVL was 85% (52/61). Salvage FLPVL results in good tumor control and incompletely satisfactory functional results and may be recognized as a safe procedure.

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