Salvage Laryngectomy for Failed Conservative Treatment of Laryngeal Cancer

Abstract

Salvage laryngectomy is an uncommon procedure (7% over 10-year period). There is no difference in survival after salvage laryngectomy for radiation or chemoradiation failure. Patients failing chemoradiation have longer PSL-ITD than those failing radiation alone. Patients with T3-4 tumors tend to be younger. T-stage of tumor does not affect rate of salvage procedure. Fistulae formed in 20%. Neither location nor differentiation affects survival. Surgical salvage after primary conservative treatment is associated with an approximately 2-year survival.

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

“…12,18,23 The remainder of the variables in this study did not prove to be significantly associated with any of the three outcomes. This is in accordance with the literature: age, 10,22 alcohol, 9,11 smoking status, 9,11 medical comorbidity, 9,11,18 T classification, [8][9][10][11][12]14,21 time from start of radiotherapy to salvage TL 11 and flap reconstruction. 11 Residual tumour and recurrence: comparison with other studies Our findings that 9.2% of the study population had residual tumour and 33.8% developed a recurrence are in accordance Survival after salvage total laryngectomy 343 with the literature, showing results between 21% and 43.2%.…”

“…We cannot make any conclusions from our findings because we were not able to apply the variable to a multivariate analysis. Others have found conflicting results …”

“…Others have found conflicting results. 21,22 We hypothesised that the variable hypopharyngeal tumour site would be a predictor of worse survival outcomes compared to primary laryngeal cancer. We were, however, unable to demonstrate this relationship in multivariate analysis, perhaps due to a small number of patients with hypopharyngeal cancer (n = 17).…”

Elucidation of salvage laryngectomy pathologic and clinical variables to guide further treatment intensification investigation

“…Most series in the literature on salvage treatment are small and limited in scope. The focus of these studies primarily have been on the complications associated with salvage laryngectomy . The larynx has been identified as a favorable site in the early study of prognostic factors of reirradiation for recurrent head and neck cancer …”

“…The focus of these studies primarily have been on the complications associated with salvage laryngectomy. 6,11,[20][21][22][23][24][25] The larynx has been identified as a favorable site in the early study of prognostic factors of reirradiation for recurrent head and neck cancer. 26 We have examined functional and oncologic outcomes of salvage laryngectomy at our own institution in the past 17,18 but have significantly increased our series, with a focus on elucidating the clinical and pathologic factors to better address the question of which patients may best be considered for treatment intensification after salvage laryngectomy.…”