Influence of the vocal cord mobility in salvage surgery after radiotherapy for early-stage squamous cell carcinoma of the glottic larynx

Abstract

Disease relapses occur in up to 40% of cases after radiotherapy (RT) for early-stage glottic laryngeal neoplasms, and the foremost remaining treatment option is salvage total laryngectomy (STL). Our objectives were to review the outcomes of patients treated with salvage surgery after RT for early-stage carcinoma of the glottic larynx and to assess prognostic factors. We retrospectively analyzed 43 patients who underwent surgery. Overall and disease-free survival rates among subgroups were calculated and compared, stratified by preoperative stage, vocal cord mobility and postoperative histopathologic data. Recurrences occurred 22.7 months after the end of RT. Surgery was STL in 33 cases (76.8%). The main prognostic factors associated with survival rates were initial vocal cord mobility, vocal cord mobility at the diagnosis of recurrence, and changes in mobility. Vocal cord mobility is an important clinical criterion in treatment decision making for early-stage glottis carcinoma and remains important during follow-up.

Vocal fold mobility as the main prognostic factor of treatment outcomes and survival in stage II squamous cell carcinomas of the glottic larynx

“…There was no difference in overall survival, probably because of the lower success rate for salvage procedures after initial surgery than after radiotherapy. For patients with impaired vocal fold mobility (T 2b ), all efficacy end-points were better after surgery rather than radiotherapy, probably because of the lower success rate of salvage therapy for T 2b than for T 2a lesions, as previously reported 5 , 22 . The lack of a difference in efficacy end-points between radiotherapy and chemoradiotherapy is consistent with the low success rate of salvage surgery after failure of these treatments in T 2b tumour patients.…”

Transoral laser microsurgery or total laryngectomy for recurrent squamous cell carcinoma of the larynx: Retrospective analysis of 199 cases

“…The patients reported here constitute a highly homogenous collective treated by TLM initially with the results of repeated TLM or total laryngectomy contrasted for early and advanced tumors in separate groups. Recent investigations into the treatment of recurrent laryngeal cancer, however, have placed more focus on radiorecurrence with less studies covering recurrences after initial surgery …”