Factors influencing long-term survival following salvage total laryngectomy after initial radiotherapy or conservative surgery

Head Neck. 2006 Feb;28(2):99-106. doi: 10.1002/hed.20297.

Abstract

Background: This retrospective study investigated survival outcomes of salvage total laryngectomy (STL) after initial radiation therapy (RT) or larynx conservation surgery (CS) at an academic center.

Methods: A chart review yielded 64 patients with STL: 53 with RT failures, six with CS failures, and five after RT + CS. Median potential follow-up after STL was 9.4 years (mean, 9.2 years; range, 0.3-17.4 years).

Results: Five- and 10-year actuarial overall survival (OS) after STL was 65.2% and 37.7%, respectively. Mean survival after STL was 7.2 years (median, 6.8 years; range, 0.2-17.4 years). No significant survival difference was found between the three treatment groups (p = .50). For 21 patients with nodes assessed at STL, 9-year OS was 45.4% for patients with N0 disease versus 26.7% for patients with N+ disease (p = .25).

Conclusion: These data suggest that STL after radiation failure is associated with equivalent long-term survival as STL after RT + CS or after failure of CS alone.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / mortality
  • Carcinoma / surgery*
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery*
  • Retrospective Studies
  • Salvage Therapy*
  • Survival Rate