Salvage Surgery for Radiation Failures in Early(T1N0, T2N0) Glottic Cancer

Kim, Jeong Kyu; Sohn, Jin Ho; Park, June Sik

Abstract

BACKGROUND AND OBJECTIVES: This study was undertaken to analyze the complications, recurrences, functional results and survival in patients undergoing salvage surgery for recurrent glottic cancers after previous radiotherapy.
SUBJECTS AND METHOD
Records of twenty-seven patients were retrospectively reviewed. There were 26 men and 1 woman with the median age of 63 years. The stage at initial treatment was T1a in 16 patients, T1b in 5 patients and T2 in 6 patients. Fifteen patients underwent total laryngectomy, and 12 patients had partial laryngectomy. Neck dissection was combined for 2 patients who had recurred neck metastasis and for 3 patients electively. All patients have been followed up for at least 1 year or until their death (6-159 months, median 31 months).
RESULTS
Overall voice preservation was achieved in 29.6% of the patients. The 5-year overall survival and disease-specific survival rates were 75.0% and 81.2%, respectively. Early and late complications, duration of hospital stay, local recurrences, neck recurrences and disease-specific survival were not significantly different between partial and total laryngectomy. Duration of tube feeding was shorter in partial laryngectomy (p=0.016). Neck recurrence was the most common cause of death, and it occurred in patients with recurred tumor that was locally advanced or re-recurrent after salvage surgery.
CONCLUSION
In selected cases, recurrences after failure to radiotherapy in T1-T2 glottic cancer could be salvaged with partial laryngectomy with adequate tumor control and acceptable morbidity. Elective neck dissection is recommended in locally advanced recurrent or re-recurrent glottic cancer.