Supracricoid laryngectomy with CHEP: Functional results and outcome

OBJECTIVES: To assess whether supracricoid laryngectomy with cricohiodoepig lottopexy could successfully reach the cure and preserve the voice in glott ic laryngeal cancer, we studied 27 patients with T2/T3 squamous cell carcin oma of the larynx treated in our institution with cricohiodoepiglottopexy. STUDY DESIGN: A retrospective analysis has been carried out between 1995 th rough 1997. We classified 11 patients as T2N0M0 and 16 patients as T3N0M0. Nineteen patients had bilateral selective lateral neck dissection, 3 patien ts had unilateral lateral neck dissection, and 5 patients had undissected n eck. Survival was analyzed under the Kaplan-Meyer method. RESULTS: Five patients had postoperative complications, 2 were treated with a total laryngectomy. The remaining 25 patients kept the normal airway, sw allowing, and speech. None of the patients in the neck dissection group had neck metastasis. Two patients had recurrences, 1 with local recurrence was treated with a total laryngectomy and is alive without disease; the other patient had neck recurrence, was treated with radical neck dissection plus radiotherapy, and is dead of the disease. One patient had a second tumor in oropharynx treated with palliative radiotherapy and is dead of the disease . Three years disease-free survival was 75% for T2 and 79% for T3. CONCLUSIONS: This technique is useful in the treatment of selected cases of T3/T2 glottic cancer regarding the extent of disease. The incidence of com plications in need of a complete laryngectomy does not compromise the funct ionality of this technique. The survival is comparable to patients who subm itted to total laryngectomy and near-total laryngectomy, regarding the exte nt of the lesion.