Results of surgical salvage for radiation failures of laryngeal carcinoma

Otolaryngol Head Neck Surg. 1995 Mar;112(3):405-9. doi: 10.1016/s0194-5998(95)70274-1.

Abstract

The results of surgical salvage of radiation failures of laryngeal carcinoma were reviewed. There were 167 stage T3 and T4 patients. The operative mortality was 7%. The complication rates were 8% wound infection, 13% chest complication, and 25% anastomotic leakage. After the first salvage operation, pharyngeal recurrence developed in 28 (18%) patients. Seven (25%) patients were feasible for second salvage operation, and none of them had further local recurrence. There were 9 (5%) tracheostomal recurrences. Of the 126 N0 patients, 23 (18%) had nodal recurrence, and only 5 of the nodal recurrences were feasible for salvage by radical neck dissection. All 41 node-positive patients underwent radical neck dissection, and 9 (23%) had nodal recurrence. Of the 126 node-negative patients, 19 (15%) had distant metastasis. Of the 41 node-positive patients, 18 (44%) had distant metastasis. The node-positive patients had a significantly high distant failure rate despite locoregional control of tumor. The adjusted 5-year survival rate of T3-4N0M0 was 45%, and that of T3-4N + M0 was 22%.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical / adverse effects
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / secondary
  • Carcinoma, Squamous Cell / surgery*
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / radiotherapy*
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / adverse effects
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neck Dissection
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Pharyngeal Neoplasms / surgery
  • Pharyngectomy / adverse effects
  • Salvage Therapy*
  • Surgical Flaps / adverse effects
  • Surgical Wound Infection / etiology
  • Survival Rate
  • Tracheal Neoplasms / surgery
  • Tracheostomy / adverse effects
  • Treatment Failure