Clinical Outcome of Salvage Treatment for Recurrent Supraglottic Cancer

Kim, Ji Heui; Lee, Yoon Se; Kwon, Min Su; Roh, Jong Lyel; Choi, Seung Ho; Kim, Sang Yoon; Nam, Soon Yuhl

Abstract

BACKGROUND AND OBJECTIVES: It is difficult to treat recurred supraglottic cancer safely and preserve physiologic function of the larynx. This study was designed to review the clinical manifestations of recurrent supraglottic cancer and compare the results of each salvage treatments.
SUBJECTS AND METHOD
During the period from Jan 2000 to Sep 2007, thirty recurrent supraglottic cancers were reviewed retrospectively. Their mean follow-up period was 30.8+/-20.1 months. We investigated initial treatment methods, stage, recurrent sites and salvage methods, and analyzed the oncological results including disease-specific survival and overall survival.
RESULTS
Ninety-seven percent of all recurrence occurred within 3 years and 76.7% of all recurrence were diagnosed at stage III-IV when recurrence was detected. Five-year disease-specific survival rate was 28.4% and five-year overall survival rate was 73.4%. Recurrence at the primary site showed significantly better overall survival rate than that at the lymph node, primary and lymph node recurrence, or distant metastasis (p=0.008). Patients who were salvaged with total laryngectomy had significantly better disease-specific survival rate and overall survival rate (p< 0.001).
CONCLUSION
With careful selection of salvage treatment for recurrent supraglottic cancer, acceptable oncological result can be achieved. Further study for laryngeal preservation for recurrent cases is necessary.