NEAR-TOTAL LARYNGECTOMY FOR TREATMENT OF ADVANCED LARYNGEAL-CANCER

BACKGROUND: In order to assess whether near-total laryngectomy (NTL) c ould successfully reach the cure and preserve the voice in advanced la ryngeal cancer, we studied 28 patients with T3/T4 squamous cell carcin oma of the larynx treated with NTL in our institution. METHODS: A retr ospective analysis has been carried out from 1990 through 1994. We cla ssified 24 patients as Stage III and 4 patients as Stage IV. All patie nts had lateral neck dissection. Survival was analyzed under the Kapla n-Meier method. RESULTS: Twenty-six patients achieved voice preservati on. Two patients in the bilateral neck dissection group had a metastat ic lymph node on the opposite side. No patient had local recurrence. T hree patients died of the disease, and 1 patient was salvaged with nec k dissection. Three-year disease-free survival was 85%. CONCLUSION: Th is technique is useful in the treatment of selected cases of advanced laryngeal cancer and achieves local control of the lesion in all cases . The survival is comparable with that of patients submitted to total laryngectomy, regarding the extent of lesion. Voice preservation can b e achieved in most cases. (C) 1997 by Excerpta Medica, Inc.