A Clinical Analysis of Stomal Recurrence / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Stomal recurrence is defined as a diffuse infiltration of neoplastic tissue at the junction of amputated trachea and skin. The incidence of stomal recurrence has been reported to be 5-15% and it is regarded to be related with several risk factors such as subglottic extension of tumor, advanced T stage, paratracheal lymph node metastasis, previous tracheotomy or the invasion of thyroid gland. The principal treatment is an extensive surgery, however, the prognosis is often extremely poor. Therefore, prevention is regarded to be much more important. The purpose of this study was to evaluate the clinical characteristics of stomal recurrence and to clarify the associated risk factors, methods of prevention and proper management. MATERIALS AND METHODS: We reviewed the data of 178 followed-up patients who underwent total laryngectomy for laryngeal or hypopharyngeal cancers from 1987 to 1996. Among them, 10 cases of stomal recurrence were studied. RESULTS: The overall incidence of stomal recurrence was 5.6% and there was no significant difference according to primary site, T stage and N stage. Subglottic involvement of tumor and previous tracheotomy were positively correlated with the increased incidence of stomal recurrence. CONCLUSION: For cases with such risk factors as considered here, more extensive and meticulous surgery is required. Considering the high rate of mortality, the effort for prevention of stomal recurrence is much more important.