Partial frontolateral laryngectomy with epiglottic reconstruction for management of early-stage glottic carcinoma

Objectives: The aim of this study was to demonstrate that partial frontolat eral laryngectomy with epiglottic reconstruction (PFLER) is an effective th erapeutic option for treatment of T1 and T2 glottic carcinoma. Study Design : Retrospective study. Methods: Between 1982 and 1997, we treated 127 cases of early glottic carcinoma with PFLER. Early glottic carcinoma was staged using the Union Internationale Contre le Cancer TNM classification as eithe r T1N0M0 (62 cases) or T2N0M0 (65 cases). Selection criteria, depending on the limits of exeresis, must remain glottic carcinoma with less than 0.5 cm of anterior subglottic involvement, with no involvement of the supraglotti c space or laryngeal side of the epiglottis, with involvement of only one a rytenoid, and with good mobility of both arytenoids even if vocal cord mobi lity is decreased. Results: Postoperative recovery was uneventful in all ca ses, and all patients but one were able to breath and eat normally. The fai lure involved a patient with a permanent gastrostomy. As with other partial laryngectomy techniques, the main drawback of PFLER was deterioration of v oice quality. Ah patients presented hoarseness and weakness of the voice. F ive-year survival rates calculated according to the Kaplan-Meier method wer e 91% (standard error, 5%) in the T1N0M0 group and 86% (standard error, 5% in the T2N0M0 group. No recurrence was observed in the T1N0M0 group. Local control was successful in 92% in the T2N0M0 group after a median follow-up of 5 years. Conclusion: These findings show that PFLER is an effective ther apeutic option in selected cases of early T1N0M0 or T2N0M0 glottic carcinom a.