CRICOHYOIDOEPIGLOTTOPEXY FOR GLOTTIC CARCINOMA WITH FIXATION OR IMPAIRED MOTION OF THE TRUE VOCAL CORD - 5-YEAR ONCOLOGIC RESULTS WITH 112 PATIENTS

The medical charts and operative files of 112 patients (combined incep tion cohort) with well to moderately differentiated invasive glottic s quamous cell carcinoma presenting fixation (22) or impaired motion (90 ) of the true vocal cord (TVC) consecutively treated with cricohyoidoe piglottopexy (CHEF) at our institutions from 1972 to 1989 were retrosp ectively reviewed. A minimum 5-year follow-up was always achieved. The Kaplan-Meier 5-year actuarial survival, local recurrence, nodal recur rence, distant metastasis, and metachronous second primary tumor estim ate for the entire group of patients were 84.7%, 5.4%, 6.4%, 1.2%, and 10.8%, respectively. The 5-year absolute and cause-specific survival rates were 85.5% and 94.1% for patients with fixation of the TVC and 8 1.3% and 96% for patients with impaired motion of the TVC. The 5-year actuarial local control rates for patients with fixation or impaired m otion of the TVC were 95.3% and 94.4%, respectively. Local recurrence was statistically more likely inpatients with positive margins (p=.007 ). Nodal recurrence was statistically more likely in patients with loc al recurrence (p=.0005). Permanent tracheostomy related to postoperati ve laryngeal stenosis was requested in 2 patients. Aspiration-related completion total laryngectomy and/or permanent gastrostomy were never requested, Overall, local control and laryngeal preservation were achi eved in 97.3%, and 95.5% of patients, respectively. At our institution s, the change from the conservative treatment modalities of radiothera py and vertical partial laryngectomy to CHEF has brought about an incr ease in long-term survival, local control, and laryngeal preservation rates when compared to historical controls using vertical partial lary ngectomy or radiotherapy.