Open partial horizontal laryngectomy for salvage after failure of CO2 laser-assisted surgery for glottic carcinoma

Abstract

Total laryngectomy (TL) is often still recommended as a salvage approach for recurrent laryngeal squamous cell carcinoma (LSCC). Considering LSCC recurrences after the failure of primary transoral laser microsurgery (TLM), open partial horizontal laryngectomy (OPHL) could be a valid alternative to TL in selected patients. The aim of the present study was to analyze retrospectively the oncological outcome of a consecutive series of 17 patients treated at the Otolaryngology Unit of Vittorio Veneto Hospital (Italy) with OPHL after primary TLM had failed. Nine patients (53 %) had no further recurrences after salvage OPHL. Eight patients had a second recurrence of LSCC after OPHL, and five of them were cured by further salvage treatment, while the other three died of their disease. We found an overall and disease-specific survival both of 82 % and a loco-regional control rate and an ultimate organ preservation rate of 82 and 70 %, respectively. Patients who underwent two-stage bilateral cordectomy for primary glottic carcinoma showed a trend towards a higher rate of second recurrences, a lower ultimate organ preservation rate and a shorter disease-free survival after salvage OPHL. Further studies on larger cohorts of patients are needed to identify potential clinical and/or pathological prognostic parameters capable of pinpointing patients at higher risk of second recurrences after salvage OPHL in cases where TLM has failed. A salvage TL might be reasonably proposed as a first salvage choice in such cases.

DOI: 10.1007/s00405-015-3734-2

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Cite this paper

@article{Lucioni2015OpenPH, title={Open partial horizontal laryngectomy for salvage after failure of CO2 laser-assisted surgery for glottic carcinoma}, author={Marco Lucioni and Andy Bertolin and Marco Lionello and Luciano Giacomelli and Giuseppe Rizzotto and Gino Marioni}, journal={European Archives of Oto-Rhino-Laryngology}, year={2015}, volume={273}, pages={169-175} }