Stomal recurrence following laryngectomy.

The extent of subglottic involvement and preoperative tracheostomy, appear to be the most important causative factors in peristomal carcinoma. Our case histories have demonstrated tumor foci in a tracheopstomy tract and in pretracheal lymphatics. Once established, the prognosis of the lesion is grave. Radiation and chemotherapy offer only limited palliation, and extensive resection offers the best chance of cure at the present time. Prophylactic measures such as avoiding a preliminary tracheostomy, meticulous paratracheal dissection, and microscopic control of the resected margins of the surgical specimen may reduce the incidence of peristomal carcinoma.