U Schroeder1, B Wollenberg2, K L Bruchhage2. 1. Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Schleswig Holstein, Ratzeburger Allee 160, 23538, Lübeck, Deutschland. ursula.schroeder@uksh.de. 2. Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Schleswig Holstein, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
Abstract
BACKGROUND: Transoral laser microsurgery (TLM) is the method of choice for partial laryngectomy in Germany. In advanced stages, chemoradiotherapy is increasingly indicated for organ preservation. OBJECTIVE: This report considers the indications for and outcomes of supracricoid partial laryngectomy (SPL), also known as crico-hyoido-(epiglotto)-pexy, as an option for surgical organ preservation in moderately advanced laryngeal cancer (T3-T4a), in the well-defined gap between TLM and chemoradiotherapy protocols in Germany. METHODS: Retrospective evaluation of functional and oncological outcomes of all SPLs conducted between 2008 and 2014. During this period, 17 SPLs with resection of rpT2 (n = 2), (r)pT3 (n = 11), and (r)pT4a (n = 4) were performed with resection of one arytenoid. Mean age was 58 years (range 47-75 years). In 5 patients, SPL was for a first or second local recurrence after TLM or open partial laryngectomy. Adjuvant radiotherapy was received by 7 patients staged pT4a or pN+. RESULTS: Salvage laryngectomy with adjuvant radiotherapy was required by 2 patients. The remaining patients (n = 15) had a mean tumor-free follow-up of 4 years with a functional intact larynx: these patients can eat and drink, have a closed tracheotomy, and a good voice. After 3 years tumor-free follow-up with a functional intact larynx, 2 patients died due to cardiac comorbidity at the age of 76 years. DISCUSSION: SPL is a rare but valuable option for surgical larynx preservation in stage pT3-4a laryngeal cancer.
BACKGROUND: Transoral laser microsurgery (TLM) is the method of choice for partial laryngectomy in Germany. In advanced stages, chemoradiotherapy is increasingly indicated for organ preservation. OBJECTIVE: This report considers the indications for and outcomes of supracricoid partial laryngectomy (SPL), also known as crico-hyoido-(epiglotto)-pexy, as an option for surgical organ preservation in moderately advanced laryngeal cancer (T3-T4a), in the well-defined gap between TLM and chemoradiotherapy protocols in Germany. METHODS: Retrospective evaluation of functional and oncological outcomes of all SPLs conducted between 2008 and 2014. During this period, 17 SPLs with resection of rpT2 (n = 2), (r)pT3 (n = 11), and (r)pT4a (n = 4) were performed with resection of one arytenoid. Mean age was 58 years (range 47-75 years). In 5 patients, SPL was for a first or second local recurrence after TLM or open partial laryngectomy. Adjuvant radiotherapy was received by 7 patients staged pT4a or pN+. RESULTS: Salvage laryngectomy with adjuvant radiotherapy was required by 2 patients. The remaining patients (n = 15) had a mean tumor-free follow-up of 4 years with a functional intact larynx: these patients can eat and drink, have a closed tracheotomy, and a good voice. After 3 years tumor-free follow-up with a functional intact larynx, 2 patients died due to cardiac comorbidity at the age of 76 years. DISCUSSION: SPL is a rare but valuable option for surgical larynx preservation in stage pT3-4a laryngeal cancer.
Entities:
Keywords:
Cricoid cartilage; Laryngeal cancer; Larynx preservation; Partial laryngectomy; Surgery
Authors: Martin Canis; Alexios Martin; Friedrich Ihler; Hendrik A Wolff; Martina Kron; Christoph Matthias; Wolfgang Steiner Journal: Head Neck Date: 2013-09-02 Impact factor: 3.147
Authors: Martin Canis; Friedrich Ihler; Alexios Martin; Hendrik A Wolff; Christoph Matthias; Wolfgang Steiner Journal: Eur Arch Otorhinolaryngol Date: 2013-02-14 Impact factor: 2.503