EARLY GLOTTIC CARCINOMA TREATED WITH OPEN LARYNGEAL PROCEDURES

Objective: The purpose of this study was to determine the recurrence r ate and long-term survival of patients treated with open cervical proc edures. Design: The study is a retrospective analysis of a cohort of p atients who underwent an open laryngeal procedure between 1976 and 198 6. The median follow-up was 6.6 years. Patients/Participants: The samp le was a consecutive series of 159 patients with early glottic carcino ma without impaired vocal cord mobility. Patients with a history of ra diation therapy or surgical treatment elsewhere were excluded. Interve ntion: Surgical treatment in this group of 159 patients included 82 fr ontolateral partial vertical laryngectomies, 61 laryngofissures with c ordectomy, 12 hemilaryngectomies, and four anterior commissure procedu res. Outcome Measure: Estimates of survival time beyond the day of sur gery, time to first recurrence (local, regional, and distant), and tim e to first local recurrence were obtained with the Kaplan-Meier produc t-limit method. Results: Eleven patients experienced recurrent larynge al cancer. Ten patients underwent laryngectomy for recurrence. One pat ient underwent an anterior commissure procedure. Three of the 11 patie nts who underwent re-treatment of the larynx were ultimately salvaged. The probability of survival at 3 and 5 years was 91% and 84%, respect ively. The probability of remaining free of local recurrence 3 and 5 y ears after surgery was 94% and 93%, respectively. Conclusion: In our e xperience, open laryngeal procedures continue to be excellent treatmen t for select cases of early glottic carcinoma. They are versatile and efficacious for managing the wide spectrum of larger T1 glottic carcin omas.