PROGNOSIS OF RECURRENT LARYNGEAL CARCINOMA AFTER LARYNGECTOMY

Background. Recurrence is common after total laryngectomy for advanced laryngeal carcinoma. The aim of the present study was to review the p rognosis of recurrent laryngeal carcinoma after total laryngectomy. Me thods. The records of 165 patients who developed recurrences after tot al laryngectomy for laryngeal squamous cell carcinoma between January 1971 and December 1990 were reviewed. Results. Of the 165 patients who developed recurrences, 34 (21%) patients had surgical salvage. The si tes of recurrence of these 34 operable patients included 11 pharyngeal , 3 tracheostomal, 15 nodal, 2 pharyngeal with nodal, and 3 pulmonary metastasis. Pharyngeal recurrence had the highest salvage rate, follow ed by nodal and pulmonary recurrence. All patients with tracheostomal had recurrence after salvage surgery. After the surgical salvage, the tumor recurrence rate was 44% and the 5-year actuarial survival rate w as 42%. Of the other 131 patients who had palliative treatment without surgical salvage, the 5-year actuarial survival rate was 2%. Conclusi ons. The present study showed that patients who had surgical salvage f or recurrent tumor after total laryngectomy had satisfactory prognosis . Close follow-up of patients after initial operation is essential to detect recurrence early, while surgical salvage is still feasible. (C) 1995 John Wiley & Sons, Inc.