PARTIAL LARYNGECTOMY IN THE TREATMENT OF RADIATION-FAILURE OF EARLY GLOTTIC CARCINOMA

Background: This study was undertaken to analyze the functional result s, complications, local control rates, and survival in patients underg oing conservation surgery for squamous cell carcinoma (SCC) of the lar ynx as a salvage procedure for recurrent tumors after previous radioth erapy. Methods: Twenty-one patients underwent frontolateral laryngecto my for radiation failure, TI and T2 glottic SCC, at the Cancer Institu te Hospital, Tokyo, from 1976 to 1991. All patients were men between t he ages of 42 and 83 years. The disease-free interval ranged from 1 to 87 months (median, 26 months). The stage at initial treatment was T1 in 17 patients and T2 in four patients. Local recurrence developed in three patients. Results: The rate of local control was influenced by a surgical margin of less than 1 mm (p < 0.05). Overall voice preservat ion was achieved in 86% of the patients. The 5-year and 10-year surviv al rates following frontolateral laryngectomy were 86% and 70%, respec tively. Maximum phonation time after surgery ranged from 4 to 18 secon ds (median, 8.1 seconds). Conclusions: These results indicate that in carefully selected cases, frontolateral laryngectomy may be used for t reating radiation failure stage I or II vocal cord carcinomas with goo d success. Careful follow-up may be necessary in patients with a close surgical margin. (C) 1997 John Wiley & Sons, Inc.