BACKGROUND: The purpose of this present study was to investigate risk factors for local recurrence and death after total laryngectomy, with particular emphasis on pattern of local recurrence (stomal vs pharyngeal/base of tongue) and impact of preceding tracheostomy. METHODS: We conducted a retrospective review of 75 consecutive total laryngectomies for cancer of the larynx. RESULTS: Nineteen patients underwent preoperative tracheostomy, which was a significant risk factor for local recurrence (p = .04). With regard to pattern of local recurrence, preoperative tracheostomy (p = .03) and pathological nodal status (pN+; p = .04) were significant for stomal, but not pharyngeal recurrence; whereas positive margins (p = .01) was significant for pharyngeal, but not stomal recurrence. Preoperative tracheostomy, pN+, lymphovascular invasion, and positive margins were all significant for survival. CONCLUSION: Preoperative tracheostomy continues to be a significant adverse prognosticator in patients undergoing total laryngectomy. Our findings also suggest distinct causative factors for different patterns of postlaryngectomy local recurrence.
BACKGROUND: The purpose of this present study was to investigate risk factors for local recurrence and death after total laryngectomy, with particular emphasis on pattern of local recurrence (stomal vs pharyngeal/base of tongue) and impact of preceding tracheostomy. METHODS: We conducted a retrospective review of 75 consecutive total laryngectomies for cancer of the larynx. RESULTS: Nineteen patients underwent preoperative tracheostomy, which was a significant risk factor for local recurrence (p = .04). With regard to pattern of local recurrence, preoperative tracheostomy (p = .03) and pathological nodal status (pN+; p = .04) were significant for stomal, but not pharyngeal recurrence; whereas positive margins (p = .01) was significant for pharyngeal, but not stomal recurrence. Preoperative tracheostomy, pN+, lymphovascular invasion, and positive margins were all significant for survival. CONCLUSION: Preoperative tracheostomy continues to be a significant adverse prognosticator in patients undergoing total laryngectomy. Our findings also suggest distinct causative factors for different patterns of postlaryngectomy local recurrence.
Authors: Patrick Tassone; Corey Savard; Michael C Topf; William Keane; Adam Luginbuhl; Joseph Curry; David Cognetti Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-11-01 Impact factor: 6.223
Authors: Andrew C Birkeland; Andrew J Rosko; Lauren Beesley; Emily Bellile; Steven B Chinn; Andrew G Shuman; Mark E Prince; Gregory T Wolf; Carol R Bradford; J Chad Brenner; Matthew E Spector Journal: Otolaryngol Head Neck Surg Date: 2017-06-06 Impact factor: 3.497