Salvage Surgery for Radiation Failures in Early(T1N0, T2N0) Glottic Cancer / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: This study was undertaken to analyze the complications, recurrences, functional results and survival in patients undergoing salvage surgery for recurrent glottic cancers after previous radiotherapy. SUBJECTS AND METHOD: Records of twenty-seven patients were retrospectively reviewed. There were 26 men and 1 woman with the median age of 63 years. The stage at initial treatment was T1a in 16 patients, T1b in 5 patients and T2 in 6 patients. Fifteen patients underwent total laryngectomy, and 12 patients had partial laryngectomy. Neck dissection was combined for 2 patients who had recurred neck metastasis and for 3 patients electively. All patients have been followed up for at least 1 year or until their death (6-159 months, median 31 months). RESULTS: Overall voice preservation was achieved in 29.6% of the patients. The 5-year overall survival and disease-specific survival rates were 75.0% and 81.2%, respectively. Early and late complications, duration of hospital stay, local recurrences, neck recurrences and disease-specific survival were not significantly different between partial and total laryngectomy. Duration of tube feeding was shorter in partial laryngectomy (p=0.016). Neck recurrence was the most common cause of death, and it occurred in patients with recurred tumor that was locally advanced or re-recurrent after salvage surgery. CONCLUSION: In selected cases, recurrences after failure to radiotherapy in T1-T2 glottic cancer could be salvaged with partial laryngectomy with adequate tumor control and acceptable morbidity. Elective neck dissection is recommended in locally advanced recurrent or re-recurrent glottic cancer.