A Clinical Study of Extended-Conservation Surgery in Laryngeal Cancer / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: The surgical goals of laryngeal cancer should not only be to preserve life but also to preserve laryngeal functions such as airway, aspiration prevention, and voice production. Classic, standard conservation laryngectomy such as horizontal supraglottic laryngectomy and vertical hemilaryngectomy has served well to those purposes but has the limits of resection. And so extended conservation laryngeal surgery was developed to extend surgical resection margin if we carefully select surgical indication. Our study was to determine the best surgical method according to the extent of tumor and evaluate the surgical outcome oncologically and physiologically in extended conservation laryngectomy. MATERIALS AND METHODS: Forty patients were treated with extended conservation surgery in laryngeal cancer at Department of Otorhinolaryngology, Head and Neck Surgery, at the Hallym university hospitals according to surgical algorithm invented by author (Young Min Kim, MD)from 1992 to 1998. They were reviewed retrospectively with respect to age, sex, endoscopic and radiologic evaluation, primary site, extended site, postoperative complications and results. RESULTS: Thirteen patients had glottic cancer, and were treated with extended vertical laryngectomy. Two patients showed recurrence at the primary site or neck nodes, one patient died due to other disease. Ten patients (76.9%)are alive without disease. Twenty-seven patients were supraglottic cancer. They treated with extended horizontal laryngectomy. Twenty patients (74.1%)are alive without disease. Three patients recurred at primary site or neck nodes. CONCLUSION: Extended conservation surgery was oncologically safe in both glottic and supraglottic cancer. Functional outcome was relatively satisfactory and so we could avoid total or near-total laryngectomy with careful evaluation of tumor extent.