Coronal sections of larynges from radiation-therapy failures: a clinical-pathologic study.

Serial coronal sections of 89 wide-field laryngectomies were examined. Twenty were specimens obtained from laryngectomies to treat patients for whom primary radiation therapy failed to cure early laryngeal cancer. These specimens were compared to 69 specimens from laryngectomies for T3 and T4 laryngeal cancers. The irradiation-failure group showed a significantly greater invasion of cartilage and extension into subglottic areas. The extension of tumors along blood vessels and mucous glands appeared to contribute to the spread of tumors in the irradiation-failure group. These findings have implications for the surgical management of irradiation failures in the treatment of laryngeal cancers.