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Twenty-year experience with salvage total laryngectomy: lessons learned

Published online by Cambridge University Press:  05 July 2021

N Tsetsos ,
A Poutoglidis ,
K Vlachtsis ,
M Stavrakas ,
A Nikolaou  and
G Fyrmpas
N Tsetsos*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Thessaloniki, Greece
A Poutoglidis
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Thessaloniki, Greece
K Vlachtsis
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Thessaloniki, Greece
M Stavrakas
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Derriford Hospital University Hospitals Plymouth NHS Trust, Plymouth, UK
A Nikolaou
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Thessaloniki, Greece
G Fyrmpas
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Thessaloniki, Greece
*
Author for correspondence: Dr Nikolaos Tsetsos, Department of Otorhinolaryngology – Head and Neck Surgery, ‘G. Papanikolaou’ General Hospital, Exochi, Thessaloniki57010, Greece E-mail: tsetsosnikos@yahoo.gr
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Abstract

Objective

The purpose of this study was to evaluate the outcome of salvage total laryngectomy and identify areas for further improvement.

Method

A retrospective analysis of all patients who underwent salvage total laryngectomy between January 1999 and December 2018 was performed.

Results

Thirty-one patients were identified. The most common primary tumour site was the glottis (83.8 per cent). Early stage (T1–T2) disease was identified in 83.9 per cent of cases. Overall survival at 2 and 5 years post-salvage total laryngectomy was 71 per cent and 45 per cent, respectively. Disease-free survival at 2 and 5 years post-salvage total laryngectomy was 65 per cent and 42 per cent, respectively. The rate of post-salvage total laryngectomy pharyngocutaneous fistula was 29 per cent.

Conclusion

More than half of patients will not survive beyond five years after salvage total laryngectomy. Regional recurrence was the most common form of failure and death. From this study, elective lateral and central neck dissection is advocated in patients with early laryngeal cancer who present with an advanced recurrence.

Keywords

Laryngeal NeoplasmsLaryngectomyRadiotherapyChemoradiotherapyNeck Dissection
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 8 , August 2021 , pp. 729 - 736
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr N Tsetsos takes responsibility for the integrity of the content of the paper

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