Outcomes following total laryngectomy for squamous cell carcinoma: One centre experience

Abstract

Seventy-one patients were reviewed, of whom 38 (54%) had laryngeal SCCa and 33 (46%) hypopharyngeal SCCa. The overall mean survival period following TL was 42.4 months. The 5-year DSS and DFS was better for laryngeal SCCa compared to hypopharyngeal SCCa, although not statistically significant (P=0.090, P=0.54 respectively). Patients treated for laryngeal SCCa had a mean survival period of 47.5 months compared to 36.5 months for hypopharyngeal disease. Those who had laryngeal recurrence after primary radiotherapy (RT) demonstrated statistically better survival probability than those who had hypopharyngeal recurrence (P=0.011). Patients without cervical lymphadenopathy had statistically better survival (P=0.049). The most common early complication was related to the cardiorespiratory system. One fatal complication of erosion of the brachiocephalic artery due to the laryngectomy tube was noted. The most common late complication was neopharyngeal stenosis. The commonest cause of death was due to locoregional recurrence, followed by medical co-morbidities. Patients referred to specialised head and neck clinic had a better survival probability than those referred to a general ENT clinic (P=0.37). While there is increasing tendency towards laryngeal conservation, total laryngectomy remains a robust treatment option in selected patients.

Risk factors for postoperative complications after total laryngectomy following radiotherapy or chemoradiation: a 10‐year retrospective longitudinal study in Eastern Denmark

“…The frequencies of postoperative complications in our study are in accordance with the literature: overall postoperative complications 10–78% compared with 56,6% in our study, wound infection 4–28% (31% in our study), bleeding 2.3–12% (11.3% in our study), wound necrosis 3.7–8.1% (9.2% in our study), stenosis of the pharynx or oesophagus 0‐35% (18.2% in our study) and stoma shrinkage 9–21% (18.2% in our study). The large variability in the overall postoperative complications may be explained by differences in types of complications included in the studies, patient heterogeneity and rather small sample sizes in several studies.…”

“…In our study, only 66.7% of the fistulas were treated conservatively. The proportion of fistulas treated with surgery is in the higher end compared with other studies with numbers from 0 to 25% and only a few above this …”

“…The overall frequency of fistulas within one year (42.3%) and the rate of fistula formation within two months (34.5%) are also in accordance with others who report the rate of immediate fistula formation to vary between 4% and 39%. 4,[6][7][8]10,11,[14][15][16][18][19][20][21][22][23] All patients in our study have previously been treated with radiotherapy, leading to a higher risk of postoperative complications and fistula formation. Most other studies included patients treated with primary TL.…”

Prognostic factors for survival after salvage total laryngectomy following radiotherapy or chemoradiation failure: a 10‐year retrospective longitudinal study in eastern Denmark

“…Many studies have investigated these possible relationships, but surprisingly most failed to show either N classification or lymph node excision to be significantly associated with survival. Leong et al . and Klozar et al .…”

A novel extracellular drug conjugate significantly inhibits head and neck squamous cell carcinoma

“…Despite these advances, prognosis and survival has only minimally improved in this patient population [1–9]. Survival of head and neck cancer patients has slightly improved following the use local therapies, such as surgery or radiotherapy, in large part due to locoregional and distant metastatic failure [10]. While, systemic monotherapy using platinum based compounds have limited response rates except when combined with radiotherapy [11–14].…”