Recurrence Risk Factors after Radiotherapy in Early Glottic Cancer and Outcome of Salvage Treatment

Lee, Se Woo; Kim, Mu Phil; Park, Se Jin; Jung, Kwang Yoon; Woo, Jeong Soo; Kwon, Soon Young; Baek, Seung Kuk; Kim, Chul Yong

Abstract

BACKGROUND AND OBJECTIVES: The aim of this study was to find risk factors for recurrence after curative radiotherapy in early glottic cancer and to analyze the result of treatment between salvage total laryngectomy and salvage conservation laryngectomy for recurrent glottic cancer.
SUBJECTS AND METHOD
A retrospective analysis was performed for patients of 45 cases of early glottic cancer who were treated with curative radiotherapy from 1997 to 2004. The risk factors analyzed for recurrence in early glottic cancer were gender, age, anterior involvement, bilaterality, T stage and radiotherapy interruption. Fourteen patients who underwent salvage laryngectomy for recurrent glottic cancer were analyzed by Kaplan-Myer method to assess the results of salvage total laryngectomy and salvage conservation laryngectomy.
RESULTS
Forty-two patients were male and only 3 patients were female, with the median age of 62.4 years. Radiotherapy interruption was found to be a risk factor significantly influencing recurrence in univariate and multivariate analyses. The 5-year overall survival rate in salvage total laryngectomy was 77% and that in salvage conservation laryngectomy was 75%.
CONCLUSION
When a curative radiotherapy was interrupted in early glottic cancer before total dosage irradiation, the possibility of recurrence must be considered. In such cases, by choosing an adequate patient group combined with a proper surgical technique, optimal treatment results can be obtained by salvage conser-vation laryngectomy.