Salvage laryngectomy after primary radio- and radiochemotherapy : A retrospective study

Sievert M, Goncalves M, Binder B, Mueller SK, Rupp R, Koch M, Dürr S, Traxdorf M, Hecht M, Iro H, Gostian AO (2021)

Publication Type: Journal article

Publication year: 2021

Journal

HNO Springer Verlag

Book Volume: 69

Pages Range: 47-52

DOI: 10.1007/s00106-021-01030-3

Abstract

BACKGROUND: Recurrent and residual laryngeal cancer after organ-preserving radio- or radiochemotherapy is associated with a poor prognosis. Salvage surgery is the most important therapeutic option in these cases. OBJECTIVE: The study assessed rates of recurrence and residual tumor as well as survival and complication rates after salvage laryngectomy at the authors' academic cancer center. MATERIALS AND METHODS: A retrospective examination of all patients receiving laryngectomy between 2001 and 2019 due to tumor residuals or recurrence after primary radio- and radiochemotherapy was conducted. RESULTS: A total of 33 salvage procedures were performed. Defect reconstruction was performed by free flap surgery in 30.3% (n = 10) and regional flap surgery in 15.2% (n = 5) . One patient received regional flap surgery and free flap surgery simultaneously. Overall survival after 1, 2, and 5 years was 68.7, 47.9, and 24.2%, and disease-free survival was 81.6, 47.8, and 24.2%, respectively, with 48.5% (n = 16) postoperative tumor recurrences overall. Disease-free survival was significantly shorter for tumor extension into or onto the hypopharynx (p = 0.041). Postoperatively, 72.7% of patients developed a pharyngocutaneous fistula, of which 24.2% required surgical treatment. The hospital stay was 28.0 ± 16.1 days. CONCLUSION: Salvage laryngectomy is associated with a high rate of treatable complications and high morbidity. Nevertheless, considering the advanced tumor stages treated, it allows for respectable oncological results.

Authors with CRIS profile

Matti Sievert Department of Otorhinolaryngology – Head and Neck Surgery Miguel Goncalves Department of Otorhinolaryngology – Head and Neck Surgery Sarina Müller-Hübner Department of Otorhinolaryngology – Head and Neck Surgery Robin Rupp Department of Otorhinolaryngology – Head and Neck Surgery Michael Koch Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Stephan Dürr Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Maximilian Traxdorf Medizinische Fakultät Markus Hecht Department of Radiation Oncology Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Antoniu-Oreste Gostian Department of Otorhinolaryngology – Head and Neck Surgery

How to cite

APA:

Sievert, M., Goncalves, M., Binder, B., Mueller, S.K., Rupp, R., Koch, M.,... Gostian, A.-O. (2021). Salvage laryngectomy after primary radio- and radiochemotherapy : A retrospective study. HNO, 69, 47-52. https://doi.org/10.1007/s00106-021-01030-3

MLA:

Sievert, Matti, et al. "Salvage laryngectomy after primary radio- and radiochemotherapy : A retrospective study." HNO 69 (2021): 47-52.

BibTeX: Download