Artikel
Primary and salvage total laryngectomy for advanced laryngeal cancer
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Autoren
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Milan Stankovic
- ORL Clinic Nis, Nis, Serbia
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Dusan Milisavljevic
- ORL Clinic, Nis, Serbia
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Misko Zivic
- Orl Clinic, Nis, Serbia
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Dragan Stojanov
- ORL Clinic, Nis, Serbia
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Petar Stankovic
- ORL Clinic, Nis, Serbia
| Veröffentlicht: | 4. April 2012 |
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Gliederung
Text
Introduction: A retrospective review of patients with advanced malignant neoplasms of the larynx treated with total laryngectomy.
Methods: 387 total laryngectomies for advanced squamous cell carcinoma of larynx performed in the period between 1995 and 2007 were analyzed. Primary total laryngectomy (PRT) was performed in 316 patients, while initial radiotherapy radiotherapy (60-70 Gy) and concomitant chemotherapy (cisplatin-5 fluorouracil) with radiotherapy were applied in totally 71 patients who later received salvage total laryngectomy (STL). All the laryngectomies were performed by four surgeons, using the same routine surgical technique. The occurrence of local and general complications, survival rate, residual and recurrent disease, lymph node metastasis, and other changes were recorded.
Results: Salvage total laryngectomy after previous radiotherapy (STL-pRT) and after chemoradiotherapy (STL-pCTRT) caused more frequent local complications than primary total laryngectomy (PTL). TNM stage and localization of primary laryngeal tumor had significant influence on five year survival rate. It amounted: 61.4% for PTL, 52.6% for STL-pCTRT, and 48.5% for STL-pRT.
Conclusion: Salvage total laryngectomy caused more frequent local complications, especially after chemoradiotherapy whan compared to primary laryngectomy. Survival rate was increased when chemotherapy is added to radiotherapy. Five year survival rate depended on TNM stage and localization of the primary tumor.
