The Role of Conservation Laryngeal Surgery in Locally Advanced Laryngeal Cancer

Joo, Young Hoon; Sun, Dong Il; Kim, Choung Soo; Cho, Kwnag Jae; Cho, Seung Ho; Kim, Min Sik

Abstract

BACKGROUND AND OBJECTIVES: Supracricoid partial laryngectomy (SCPL) and supraglottic partial laryngectomy (SPL) are considered as a good surgical procedure for satisfactory results on oncological and functional aspects in locally advanced laryngeal cancer. The purpose of this study is to research oncological and functional results to know the efficacy and safety of SCPL and SPL in locally advanced laryngeal cancer.
SUBJECTS AND METHOD
We retrospectively reviewed the medical records of 76 patients with locally advanced squamous cell carcinoma of larynx from March 1993 to May 2006, who underwent SCPL (N=64), SPL (N=8), extened supraglottic laryngectomy (ESPL)(N=4). We investigated retrospectively recurrence and survival rate to evaluate oncological safety and decannulation, oral feeding, voice analysis to evaluate preservation of laryngeal function.
RESULTS
Seventy three patients had over 12 months follow up. In the oncologic aspect, the overall recurrence rate was 23.2% (17/73), but for the surgery only group, it was 18% (7/38). In the advanced T stage, the recurrence rate was increased without significant difference; more regional recurrence was observed in the N positive group without significant difference. Decannulation was achieved at the mean postoperative period of 23.0 days and oral diet was achieved for all patients starting at mean postoperative period 28.3 days. In the voice analysis, SCPL showed somewhat unsatisfactory results compared with SPL, but it allowed social interaction by maintaining fundamental frequency.
CONCLUSION
The oncologic aspect of both SCPL and SPL showed that they are effective methods in treating locally advanced laryngeal cancer.