Clinical and functional outcomes after total laryngectomy and laryngopharyngectomy: Analysis by tumor subsite, salvage status, and extent of resection

Head Neck. 2019 Sep;41(9):3133-3143. doi: 10.1002/hed.25807. Epub 2019 May 18.


Background: Outcomes following surgical intervention for laryngeal and hypopharyngeal tumors are dependent on several factors. In the present study, we sought to determine whether tumor subsite, salvage status, and extent of resection influenced postoperative outcomes.

Methods: Retrospective review of 107 patients at a single institution who underwent total laryngectomy or partial/total laryngopharyngectomy.

Results: Hypopharyngeal subsite and total laryngopharyngectomy subgroups had inferior speech and swallow outcomes compared to their respective cohorts (P < .05). Salvage patients had inferior 3-year overall survival (P < .05) and swallow outcomes (P < .001). Previously radiated patients had increased fistula rates (29.9% vs 10%, P = .02), and the use of tissue coverage in salvage total laryngectomy had a protective effect on fistula formation (10% vs 37%, P = .04).

Conclusions: By stratifying patients across multiple subgroups, we provide a detailed narrative in surgical outcomes that can be incorporated into treatment planning. Further prospective studies are needed to compare surgical outcomes to those of organ preservation therapy.

Keywords: hypopharyngeal cancer; laryngeal cancer; laryngopharyngectomy; salvage surgery; total laryngectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Combined Modality Therapy
  • Cutaneous Fistula / etiology
  • Female
  • Fistula / etiology*
  • Humans
  • Hypopharyngeal Neoplasms / mortality
  • Hypopharyngeal Neoplasms / surgery*
  • Hypopharyngeal Neoplasms / therapy
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / surgery*
  • Laryngeal Neoplasms / therapy
  • Laryngectomy* / adverse effects
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Pharyngeal Diseases / etiology
  • Pharyngectomy* / adverse effects
  • Postoperative Complications
  • Retrospective Studies
  • Risk Factors
  • Salvage Therapy