POSTOPERATIVE IRRADIATION OF LARYNGEAL CARCINOMA - THE PROGNOSTIC VALUE OF TUMOR-FREE SURGICAL MARGINS

Between 1972 and 1987, two hundred and live carcinoma patients were tr eated with surgery and postoperative radiotherapy. The histological co nfirmation of tumour-free margins was only predictive of significant d ifferences in locoregional control in locally advanced disease. In add ition, macroscopically assessed margins in advanced cases were predict ive of survival probability. We suggest that the adjuvant radiotherapy was able to reduce the incidence of locoregional recurrence in the ea rly stage microscopic positive group, hence the lack of a significant difference in the control rates. The effect on survival is therefore i ndirect. The advanced cases showed significantly reduced locoregional control rates and disease-specific survival times after macroscopic as sessment of positive margins, possibly a sign of tumour extension beyo nd the margins of the radiation field. We compare our results with pub lished reports of cases not receiving adjuvant therapy.