Salvage total laryngectomy after external‐beam radiotherapy: A 20‐year experience. (16th February 2016)

• Record Type: Journal Article
• Authors: Sandulache, Vlad C.; Vandelaar, Laura J.; Skinner, Heath D.; Cata, Juan; Hutcheson, katherine; Fuller, Clifton David; Phan, Jack; Siddiqui, Zuhair; Lai, Stephen Y.; Weber, Randal S.; Zafereo, Mark E.
• Is Part Of: Head & neck. Volume 38(2016)Supplement 1
• Page Start: E1962
• Page End: E1968
• Publication Date: 2016-02-16
• Subjects: laryngectomy -- squamous cell carcinoma -- recurrence -- salvage -- complications -- disease‐free interval -- fistula -- radiotherapy -- free flap; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.24355
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: The purpose of this study was to present our evaluation of the clinical and functional outcomes after salvage total laryngectomy (STL). Methods: We conducted a retrospective review of 218 patients who underwent STL between 1994 and 2014. Results: Seventy percent of patients originally had T1 or T2, N0 tumors and 73% had definitive external‐beam radiotherapy (EBRT) alone. A majority utilized tracheoesophageal prosthesis (77%) and were gastrostomy free (80%) at last follow‐up. The 5‐year disease control and overall survival (OS) rates were 65% and 57%, respectively. Patients with a disease‐free interval after initial treatment <2 years were more likely to develop a recurrence ( p = .001) and die of disease ( p = .032) after STL. The disease‐free interval after EBRT impacted disease control ( p < .001), with 5‐year disease control of 92% for >5‐year disease‐free interval and 60% for <2‐year disease‐free interval. Conclusion: Most patients remain disease‐free after STL, achieve intelligible tracheoesophageal speech, and maintain an oral diet. Delayed recurrence after initial treatment portends better survival and may indicate a distinct biological profile. © 2016 Wiley Periodicals, Inc. Head Neck 38 : E1962–E1968, 2016