Objective: To explore new methods of preservative surgery for T4 glottic cancer and to evaluate their long term results.
Methods: 22 cases with T4 glottic cancer were treated surgically from 1982 to 1998. The lesions and involved cartilage and extrinsic laryngeal tissues were removed entirely, the sternohyoid myofascial flap, platysma myocutaneous flap, platysma myofascial flap, thyroid perichondral flap and hypopharyngeal mucosa flap were utilized to restore the defects of larynx, while the epiglottis or lamina of cricoid cartilage were reserved for laryngeal function restruction.
Results: The 3- and 5-year survival rates were 86.4% and 75.0% in all cases. 68.2% had laryngeal functions(voice, respiration and deglutition) restored and 31.8% partially restored(voice and deglutition).
Conclusion: Despite the fact that the T4 glottic cancer usually involved with cartilage and extrinsic laryngeal tissues, preservative surgery can be carried out for the carefully selected cases with the lesions entirely removed.