Resultados oncológicos del tratamiento de rescate en pacientes con carcinomas de orofaringe tratados con radioterapia / Oncological results of salvage treatment in patients with oropharynx carcinoma treated with radiotherapy

Objetivo Evaluar las posibilidades de rescate tras la recidiva local en pacientes con carcinomas de orofaringe tratados con radioterapia y analizar los factores pronósticos relacionados con el control final de la enfermedad. Métodos Estudio retrospectivo de 596 con carcinomas de orofaringe pacientes tratados con radioterapia durante el periodo 1991-2018. Resultados Ciento ochenta y un pacientes (30,4%) tuvieron una recidiva local. De los pacientes con una recidiva local, 51 (28,2%) fueron tratados con una cirugía de rescate. Las variables que se relacionaron con que el paciente no recibiese una cirugía de rescate fueron una edad superior a los 75 años, la localización del tumor en la pared posterior de la hipofaringe, una extensión inicial del tumor cT4 y un intervalo libre de recidiva inferior a los 6 meses. La supervivencia específica a los 5 años de los pacientes tratados con una cirugía de rescate fue del 19,1% (IC del 95%: 7,3-30,9%). Las variables que se relacionaron con la supervivencia específica fueron la extensión de la recidiva y el estatus de los márgenes de resección. No se consiguió el control final del tumor en ninguno de los pacientes con una recidiva extensa (rpT3-4, n=25) o con unos márgenes de resección positivos (n=22). Conclusión Los pacientes con carcinomas de orofaringe tratados con radioterapia con una recidiva local del tumor cuentan con un pronóstico limitado. Una mayoría de los pacientes (71,8%) no fueron considerados candidatos a cirugía de rescate. La supervivencia específica a los 5 años de los pacientes tratados con una cirugía de rescate fue del 19,1%. (AU)

Objective To evaluate the possibilities of salvage after local recurrence in patients with oropharyngeal carcinomas treated with radiotherapy, and to analyze the prognostic factors related to the final control of the disease. Methods Retrospective study of 596 patients with oropharyngeal carcinoma treated with radiotherapy during the period 1991–2018. Results One hundred and eighty-one patients (30.4%) had a local recurrence. Of the patients with a local recurrence, 51 (28.2%) were treated with salvage surgery. Variables that were associated with the patient not receiving salvage surgery were age greater than 75 years, tumor location in the posterior hypopharyngeal wall, an initial tumor extent cT4, and a recurrence-free interval of less than 6 months. Five-year specific survival of patients treated with salvage surgery was 19.1% (95% CI: 7.3%–30.9%). Variables that were related to specific survival were extent of recurrence and status of resection margins. Final tumor control was not achieved in any of the patients with extensive recurrence (rpT3-4, n=25) or positive resection margins (n=22). Conclusion Patients with oropharyngeal carcinomas treated with radiotherapy with local tumor recurrence have a limited prognosis. Most patients (71.8%) were not considered candidates for salvage surgery. The 5-year specific survival of patients treated with salvage surgery was 19.1%. (AU)

Oncological results of salvage treatment in patients with oropharynx carcinoma treated with radiotherapy.

OBJECTIVE: To evaluate the possibilities of salvage after local recurrence in patients with oropharyngeal carcinomas treated with radiotherapy, and to analyse the prognostic factors related to the final control of the disease. METHODS: Retrospective study of 596 patients with oropharyngeal carcinoma treated with radiotherapy during the period 1991-2018. RESULTS: One hundred and eighty-one patients (30.4%) had a local recurrence. Of the patients with a local recurrence, 51 (28.2%) were treated with salvage surgery. Variables that were associated with the patient not receiving salvage surgery were age greater than 75 years, tumour location in the posterior hypopharyngeal wall, an initial tumour extent cT4, and a recurrence-free interval of less than 6 months. Five-year specific survival of patients treated with salvage surgery was 19.1% (95% CI: 7.3%-30.9%). Variables that were related to specific survival were extent of recurrence and status of resection margins. Final tumour control was not achieved in any of the patients with extensive recurrence (rpT3-4, n = 25) or positive resection margins (n = 22). CONCLUSION: Patients with oropharyngeal carcinomas treated with radiotherapy with local tumour recurrence have a limited prognosis. Most patients (71.8%) were not considered candidates for salvage surgery. The 5-year specific survival of patients treated with salvage surgery was 19.1%.

Resultados de la radioterapia en los carcinomas de orofaringe / Results of radiotherapy in oropharyngeal carcinomas

Objetivo Presentar los resultados del tratamiento con radioterapia en pacientes con carcinomas de orofaringe. Material y métodos Estudio retrospectivo de una cohorte de 359 pacientes tratados con radioterapia, incluyendo quimio- y bio-radioterapia, durante el periodo 2000-2019. Se dispuso de información del estatus del virus del papiloma humano (VPH) para 202 pacientes, de los que un 26,2% resultaron VPH-positivos. Resultados La supervivencia libre de recidiva local a los 5 años fue del 73,5% (IC 95%: 68,8-78,2%). Las variables que se relacionaron con el control local de la enfermedad en un estudio multivariante fueron la categoría de extensión local del tumor y el estatus VPH. La supervivencia libre de recidiva local a los 5 años para los pacientes con tumores cT1 fue del 90,0%, para los cT2 del 88,0%, para los cT3 del 70,6% y para los cT4 del 42,3%. La supervivencia libre de recidiva local a los 5 años para los tumores VPH-negativos fue del 67,2% y para los VPH-positivos del 93,3%. La supervivencia específica a los 5 años fue del 64,4% (IC 95%: 59,1-69,7%). Las variables que se relacionaron con la supervivencia específica en un estudio multivariante fueron el estado general del paciente, la extensión local y regional del tumor, y el estatus VPH. Conclusiones La supervivencia libre de recidiva local a los 5 años de los pacientes con carcinomas de orofaringe tratados con radioterapia fue del 73,5%. Las variables que se relacionaron con el control local fueron la extensión local del tumor y el estatus VPH. (AU)

Objective To present the results of radiotherapy treatment in patients with oropharyngeal carcinomas. Material and methodsRetrospective study of a cohort of 359 patients treated with radiotherapy, including chemo- and bio-radiotherapy, during the period 2000-2019. Information on human papillomavirus (HPV) status was available for 202 patients, of whom 26.2% were HPV-positive. Results Five-year local recurrence-free survival was 73.5% (95% CI: 68.8-78.2%). The variables that were related to local disease control in a multivariate study were the local tumor extension category and the HPV status. Five-year local recurrence-free survival for patients with cT1 tumors was 90.0%, for cT2 88.0%, for cT3 70.6%, and for cT4 42.3%. Five-year local recurrence-free survival for HPV-negative tumors was 67.2% and for HPV-positive tumors 93.3%. Five-year specific-disease survival was 64.4% (95% CI: 59.1-69.7%). Variables that were related to specific survival in a multivariate study were the patient's general condition, local and regional extent of the tumor, and HPV status. Conclusions Five-year local recurrence-free survival of patients with oropharyngeal carcinomas treated with radiotherapy was 73.5%. Variables that were related to local control were local tumor extension and HPV status. (AU)

Results of radiotherapy in oropharyngeal carcinomas.

OBJECTIVE: To present the results of radiotherapy treatment in patients with oropharyngeal carcinomas. MATERIAL AND METHODS: Retrospective study of a cohort of 359 patients treated with radiotherapy, including chemo- and bio-radiotherapy, during the period 2000-2019. Information on human papillomavirus (HPV) status was available for 202 patients, of whom 26.2% were HPV-positive. RESULTS: Five-year local recurrence-free survival was 73.5% (95% CI: 68.8%-78.2%). The variables that were related to local disease control in a multivariate study were the local tumor extension category and the HPV status. Five-year local recurrence-free survival for patients with cT1 tumors was 90.0%, for cT2 88.0%, for cT3 70.6%, and for cT4 42.3%. Five-year local recurrence-free survival for HPV-negative tumors was 67.2% and for HPV-positive tumors 93.3%. Five-year specific-disease survival was 64.4% (95% CI: 59.1%-69.7%). Variables that were related to specific survival in a multivariate study were the patient's general condition, local and regional extent of the tumor, and HPV status. CONCLUSIONS: Five-year local recurrence-free survival of patients with oropharyngeal carcinomas treated with radiotherapy was 73.5%. Variables that were related to local control were local tumor extension and HPV status.

Differential characteristics of patients with squamous cell carcinoma of the head and neck with no history of tobacco or alcohol use.

OBJECTIVE: The present study aims to analyse the differential characteristics of patients with head and neck squamous cell carcinoma (HNSCC) without a history of consumption of toxic substances such as tobacco and alcohol. MATERIAL AND METHODS: We carried out a retrospective study of 4694 patients with HNSCC located in the oral cavity, oropharynx, hypopharynx or larynx treated in our centre during the period 1985-2019. RESULT: 7.7% of the patients (n = 363) did not report a history of consumption of toxic substances. The group of patients with no toxic history was older, had a higher proportion of women, a higher frequency of cases located in the oral cavity, a higher proportion of cases diagnosed in early stages, and a lower incidence of second neoplasms. The percentage of patients with no history of consumption of toxic substances increased significantly over the study period. The overall survival of patients with no history of consumption of toxic substances was significantly higher than that of patients with toxic substances use. Specific survival for patients with tumours located in the oral cavity without a history of consumption of toxic substances was significantly lower than that of patients with toxic substances use, whereas for patients with oropharyngeal carcinomas the absence of a history of consumption of toxic substances was associated with a better prognosis. CONCLUSIONS: There were differences in the epidemiological and prognostic characteristics of patients with HNSCC according to the history of consumption of toxic substances such as tobacco and alcohol.

Características diferenciales de los pacientes con carcinoma escamoso de cabeza y cuello sin antecedentes de consumo de tabaco ni alcohol / Differential characteristics of patients with squamous cell carcinoma of the head and neck with no history of tobacco or alcohol use

Objetivo: El objetivo del presente estudio es analizar las características diferenciales de los pacientes con un carcinoma escamoso de cabeza y cuello (CECC) sin antecedentes de consumo de tóxicos, como el tabaco y el alcohol.Material y métodosSe llevó a cabo un estudio retrospectivo de 4.694 pacientes con un CECC localizado en la cavidad oral, orofaringe, hipofaringe o laringe tratados en nuestro centro durante el periodo 1985-2019.ResultadoUn 7,7% de los pacientes (n=363) no refirieron el antecedente de consumo de tóxicos. El grupo de pacientes sin antecedentes tóxicos tenía mayor edad, una mayor proporción de mujeres, una mayor frecuencia de casos localizados en la cavidad oral, una mayor proporción de casos diagnosticados en estadios iniciales y una menor incidencia de segundas neoplasias. El porcentaje de pacientes sin antecedentes de consumo de tóxicos aumentó de forma significativa a lo largo del periodo de estudio. La supervivencia global de los pacientes sin antecedentes de consumo de tóxicos fue significativamente más elevada que la de los pacientes con antecedentes tóxicos. La supervivencia específica para los pacientes con tumores localizados en la cavidad oral sin antecedentes tóxicos fue significativamente inferior, en tanto que para los pacientes con carcinomas de orofaringe la ausencia de antecedentes de consumo de tóxicos se asoció a un mejor pronóstico.ConclusionesExistieron diferencias en las características epidemiológicas y pronósticas de los pacientes con CECC en función del antecedente de consumo de tóxicos como el tabaco o el alcohol. (AU)

Objective: The present study aims to analyze the differential characteristics of patients with head and neck squamous cell carcinoma (HNSCC) without a history of consumption of toxic substances such as tobacco and alcohol.Material and methodsWe carried out a retrospective study of 4,694 patients with HNSCC located in the oral cavity, oropharynx, hypopharynx or larynx treated in our center during the period 1985-2019.ResultThe 7.7% of the patients (n=363) did not report a history of consumption of toxic substances. The group of patients with no toxic history was older, had a higher proportion of women, a higher frequency of cases located in the oral cavity, a higher proportion of cases diagnosed in early stages, and a lower incidence of second neoplasms. The percentage of patients with no history of consumption of toxic substances increased significantly over the study period. The overall survival of patients with no history of consumption of toxic substances was significantly higher than that of patients with toxic substances use. Specific survival for patients with tumors located in the oral cavity without a history of consumption of toxic substances was significantly lower than that of patients with toxic substances use, whereas for patients with oropharyngeal carcinomas the absence of a history of consumption of toxic substances was associated with a better prognosis.ConclusionsThere were differences in the epidemiological and prognostic characteristics of patients with HNSCC according to the history of consumption of toxic substances such as tobacco and alcohol. (AU)

Prognostic value of the nodal yield in elective neck dissections in patients with head and neck carcinomas.

PURPOSE: The objective of this study is to assess the prognostic capacity of the nodal yield in elective neck dissections performed in patients with head and neck squamous cell carcinomas (HNSCC) without clinical or radiological evidence of regional involvement (cN0) at the time of diagnosis. METHODS: Retrospective study including 647 patients with HNSCC treated with an elective neck dissection. RESULTS: Patients with < 15 dissected nodes (n = 172, 26.6%) had a 5-year disease-specific survival of 64.9% (95% CI: 57.3-72.5%), while for patients with ≥ 15 dissected nodes (n = 475, 73.4%), it was of 81.9% (95% CI: 78.4-85.4%) (P = 0.0001). The nodal yield category had prognostic capacity on the disease-specific survival in patients with tumors located in the oral cavity (P = 0.001), the oropharynx (P = 0.023) and the hypopharynx (P = 0.034), while for patients with tumors located in the larynx, no significant differences appeared (P = 0.779). Differences in regional recurrence-free survival were also observed based on the nodal yield category in patients with extra-laryngeal tumors (5-year regional recurrence-free survival of 81.0% in patients with < 15 dissected nodes vs 89.0% in patients with ≥ 15 dissected nodes; P = 0.046). CONCLUSION: The nodal yield in elective neck dissections in patients without evidence of lymph node disease (cN0) had prognostic capacity depending on the location of the primary tumor. For tumors located in the larynx, the number of dissected nodes did not significantly influence the prognosis. For tumors located in the oral cavity, oropharynx or hypopharynx, patients with < 15 dissected nodes had a disease-specific mortality 2.9 times higher than patients with ≥ 15 dissected nodes.

Trends in disease-specific survival of head and neck squamous cell carcinoma patients treated in a single institution over a 30-year period.

OBJECTIVE: Over the last few decades, there have been changes in the diagnostic capabilities and treatment of head and neck squamous cell carcinoma (HNSCC) patients. However, the impact of these changes on the ultimate survival of patients remains unclear. The objective of this study was to analyze the changes in disease-specific survival of patients with HNSCC treated consecutively over a period of 30 years in a tertiary center. MATERIAL AND METHODS: We carried out a retrospective analysis of 5,206 carcinomas located in the oral cavity, nasopharynx, oropharynx, hypopharynx, larynx or with metastatic squamous cell carcinoma without a known primary tumor treated in our center during the period 1985-2016. The overall and disease-specific survival was analyzed according to the year of diagnosis of the tumor. RESULTS: There was a significant trend towards an increase in disease-specific survival over the study period, with an average survival gain of 0.28% per year, which means an increase in 5-year disease-specific survival values from about 63.5% during the initial years of the study to 72% during the final years. Patients who had a greater increase in survival were those with primary tumors located in the rhino-oro-hypopharynx, with advanced tumors (stages III-IV) and treated with radiotherapy or chemoradiotherapy. This increase in disease-specific survival did not translate into overall survival. CONCLUSION: Over the last 30 years we have observed a significant increase in the disease-specific survival of the patients with HNSCC, with an average increase of 0.28% per year in the 5-year specific-disease survival.

Prognostic capacity of the weighted lymph node ratio in head and neck squamous cell carcinoma patients treated with salvage neck dissection.

PURPOSE: The aim of the study was to assess the prognostic capacity of the recently described weighted lymph node ratio (WLNR) in patients with head and neck squamous cell carcinoma (HNSCC) who undergo salvage neck dissection for regional recurrence. MATERIAL AND METHODS: We retrospectively studied 197 adult patients with head and neck squamous cell carcinoma treated with salvage neck dissection from 1990 to 2017. RESULTS: The mean value for the WLNR for all patients was 26.2%. We established a classification based on the WLNR values taking 10.8% as the cut-off point. Five-year disease-specific survival for patients with WLNR ≤ 10.8% (n = 89, 45.2%) was 39.9% (IC 95% 29.4-50.4%), and for patients with WLNR ≥ 10.8% (n = 108, 54.8%) it was 20.5% (IC 95% 12.3-28.7%) (p = 0.007). The multivariate analysis showed the WLNR had a significant prognostic capacity. CONCLUSIONS: As a variable that integrates data related to the number of metastatic nodes with extracapsular spread to the LNR, the WLNR has a prognostic value in the pathological assessment of HNSCC patients with regional recurrence treated with salvage neck dissection.

Capacidad pronóstica de la densidad ganglionar en los carcinomas escamosos de cabeza y cuello / Prognostic capacity of the lymph node ratio in squamous cell carcinomas of the head and neck

INTRODUCCIÓN Y OBJETIVOS: La densidad ganglionar o lymph node ratio (LNR), definida como el cociente entre el número total de ganglios positivos y el número total de ganglios disecados, ha demostrado una capacidad pronóstica en diferentes modelos tumorales, incluidos los pacientes con carcinomas escamosos de cabeza y cuello (CECC). El objetivo del presente estudio es analizar el valor pronóstico de la LNR en una serie amplia de pacientes con CECC. MÉTODOS: Se llevó a cabo un estudio retrospectivo de una cohorte de 1.311 pacientes con CECC tratados con vaciamientos cervicales uni o bilaterales. El 55,0% de los pacientes incluidos en el estudio contaron con la presencia de metástasis a nivel ganglionar (pN + ). Se procedió a calcular el valor de la LNR y su categorización mediante un análisis de partición recursiva considerando la supervivencia específica como la variable dependiente. RESULTADOS: Se definieron 3 categorías en función del valor de la LNR con unos puntos de corte en los valores de 0,025 y 0,118. La supervivencia específica a los 5 años para los pacientes con una LNR inferior a 0,025 (n = 654, 49,8%) fue del 87,2%, para los pacientes con LNR 0,025-0,118 (n = 394, 30,1%) del 51,6% y para los pacientes con LNR superior a 0,188 (n = 263, 20,1%) del 27,3% (p = 0,0001). De acuerdo con los resultados de un análisis multivariante, la LNR se relacionó de forma significativa con la supervivencia específica. CONCLUSIÓN: La LNR puede ser una variable pronóstica a considerar en la estadificación patológica de las áreas ganglionares

INTRODUCTION AND OBJECTIVES: Lymph node density or lymph node ratio (LNR), defined as the quotient between the total number of positive lymph nodes and the total number of dissected lymph nodes, has demonstrated a prognostic capacity in several tumour models, including patients with head and neck squamous cell carcinomas (HNSCC). The aim of the present study is to analyse the prognostic value of LNR in a wide cohort of patients with HNSCC. METHODS: We carried out a retrospective study of a cohort of 1,311 patients with HNSCC treated with unilateral or bilateral neck dissections. Of the patients included in the study, 55.0% had lymph node metastases (pN + ). We proceeded to calculate the value of the LNR, and its categorization through a recursive partition analysis considering specific survival as the dependent variable. RESULTS: Three categories were defined according to the value of the LNR with a cut-off point at the values < of .025 and .118. The 5-year specific survival for patients with an LNR less than .025 (n = 654, 49.8%) was 87.2%, for patients with a LNR .025-.118 (n = 394, 30.1%) it was 51.6%, and for patients with a LNR greater than .188 (n = 263, 20.1%) it was 27.3% (P = .0001). According to the results of a multivariate analysis, the LNR significantly related to specific survival. CONCLUSION: The LNR can be a prognostic variable to be considered in the pathological staging of the lymph nodes

Prognostic capacity of the lymph node ratio in squamous cell carcinomas of the head and neck. / Capacidad pronóstica de la densidad ganglionar en los carcinomas escamosos de cabeza y cuello.

INTRODUCTION AND OBJECTIVES: Lymph node density or lymph node ratio (LNR), defined as the quotient between the total number of positive lymph nodes and the total number of dissected lymph nodes, has demonstrated a prognostic capacity in several tumour models, including patients with head and neck squamous cell carcinomas (HNSCC). The aim of the present study is to analyse the prognostic value of LNR in a wide cohort of patients with HNSCC. METHODS: We carried out a retrospective study of a cohort of 1,311 patients with HNSCC treated with unilateral or bilateral neck dissections. Of the patients included in the study, 55.0% had lymph node metastases (pN+). We proceeded to calculate the value of the LNR, and its categorization through a recursive partition analysis considering specific survival as the dependent variable. RESULTS: Three categories were defined according to the value of the LNR with a cut-off point at the values < of .025 and .118. The 5-year specific survival for patients with an LNR less than .025 (n=654, 49.8%) was 87.2%, for patients with a LNR .025-.118 (n=394, 30.1%) it was 51.6%, and for patients with a LNR greater than .188 (n=263, 20.1%) it was 27.3% (P=.0001). According to the results of a multivariate analysis, the LNR significantly related to specific survival. CONCLUSION: The LNR can be a prognostic variable to be considered in the pathological staging of the lymph nodes.

Weighted lymph node ratio: New tool in the assessment of postoperative staging of the neck dissection in HPV-negative head and neck squamous cell carcinoma patients.

BACKGOUND: The objective of this study is to assess a new parameter, the weighted lymph node ratio (WLNR), which incorporates prognostic information regarding the number of metastatic nodes with extracapsular spread and the lymph node yield for pN0 patients to the lymph node ratio. METHODS: We studied retrospectively 1118 patients with head and neck squamous cell carcinoma (HNSCC) treated with a neck dissection. RESULTS: We obtained a classification with four categories based on the WLNR values. WLNR classification had a higher prognostic discrimination capacity and a more homogeneous distribution in the number of patients included in each of the categories than the pTNM classification. CONCLUSION: The WLNR improved the predictive capacity of the eighth edition of the pTNM classification and it can be a useful tool in the assessment of the postoperative staging of the neck dissections in HNSCC patients.

Resultados oncológicos de la laringectomía de rescate en pacientes con carcinomas escamosos de laringe / Oncological results of salvage laryngectomy in patients with laryngeal carcinoma

OBJETIVO: Analizar los resultados oncológicos conseguidos con una laringectomía total como cirugía de rescate en pacientes con carcinomas escamosos de la laringe. MATERIAL Y MÉTODOS: Revisión retrospectiva de una cohorte de 241 pacientes tratados con una laringectomía total tras una recidiva local de la enfermedad. El tratamiento inicial recibido por los pacientes fue de radioterapia (n = 201; 83,4%), quimiorradioterapia (n = 19; 7,9%), o una cirugía parcial (n = 21; 8,7%). RESULTADOS: La laringectomía total como cirugía de rescate consiguió el control local de la enfermedad en el 81,3% de las ocasiones, con una supervivencia específica a los 5 años del 65,3%. Las variables relacionadas con la supervivencia específica en un estudio univariante fueron la localización del tumor, la extensión local del tumor inicial y de la recidiva, los márgenes de resección, y el estatus patológico de los vaciamientos cervicales. De acuerdo con los resultados de un análisis multivariante, las variables que se relacionaron con la supervivencia fueron el estatus de los márgenes de resección, la presencia de una recidiva regional simultánea y la extensión local de la recidiva. CONCLUSIONES: La supervivencia específica a los 5 años de los pacientes tratados con una laringectomía total de rescate fue del 65,3%. Las variables que se relacionaron con el control final de la enfermedad fueron el estatus de los márgenes de resección, la presencia de una recidiva regional simultánea y la extensión local de la recidiva

OBJECTIVE: To analyse the oncological results of a salvage total laryngectomy in patients with a laryngeal carcinoma. MATERIAL AND METHODS: Retrospective review of a cohort of 241 patients treated with a salvage laryngectomy after a local recurrence. The initial treatment received by these patients was radiotherapy (n = 201, 83.4%), chemoradiotherapy (n=19, 7.9%), and partial surgery (n = 21, 8.7%), RESULTS: Total laryngectomy as salvage treatment achieved local control of the disease in 81.3% of cases, with a 5-year specific survival of 65.3%. The variables related with specific survival in a univariate analysis were the location of the primary tumour, the local extension of the initial tumour and of the recurrence, the resection margins, and the pathological status of the neck dissections. According to the results of a multivariate analysis, the variables related to specific survival were the status of the resection margins, the presence of simultaneous regional recurrence, and the local extension of the recurrence. CONCLUSION: The 5-year specific survival of patients treated with a salvage laryngectomy was 65.3%. The variables related with the control of the disease were the status of the resection margins, the presence of simultaneous regional recurrence and the local extension of the recurrence

Oncological results of salvage laryngectomy in patients with laryngeal carcinoma. / Resultados oncológicos de la laringectomía de rescate en pacientes con carcinomas escamosos de laringe.

OBJECTIVE: To analyse the oncological results of a salvage total laryngectomy in patients with a laryngeal carcinoma. MATERIAL AND METHODS: Retrospective review of a cohort of 241 patients treated with a salvage laryngectomy after a local recurrence. The initial treatment received by these patients was radiotherapy (n=201, 83.4%), chemoradiotherapy (n=19, 7.9%), and partial surgery (n=21, 8.7%), RESULTS: Total laryngectomy as salvage treatment achieved local control of the disease in 81.3% of cases, with a 5-year specific survival of 65.3%. The variables related with specific survival in a univariate analysis were the location of the primary tumour, the local extension of the initial tumour and of the recurrence, the resection margins, and the pathological status of the neck dissections. According to the results of a multivariate analysis, the variables related to specific survival were the status of the resection margins, the presence of simultaneous regional recurrence, and the local extension of the recurrence. CONCLUSION: The 5-year specific survival of patients treated with a salvage laryngectomy was 65.3%. The variables related with the control of the disease were the status of the resection margins, the presence of simultaneous regional recurrence and the local extension of the recurrence.