Open partial horizontal laryngectomy for salvage after failure of CO2 laser-assisted surgery for glottic carcinoma

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• 作者：Marco Lucioni ; Andy Bertolin ; Marco Lionello…
• 关键词：Glottic carcinoma ; Laser ; Salvage ; Prognosis ; Partial laryngectomy
• 刊名：European Archives of Oto-Rhino-Laryngology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：273
• 期：1
• 页码：169-175
• 全文大小：435 KB
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• 作者单位：Marco Lucioni (1)
  Andy Bertolin (1)
  Marco Lionello (1) (2)
  Luciano Giacomelli (3)
  Giuseppe Rizzotto (1)
  Gino Marioni (2)
  
  1. Otolaryngology Unit, Vittorio Veneto Hospital, Vittorio Veneto, Italy
  2. Otolaryngology Section, Department of Neurosciences DNS, University of Padova, Via Giustiniani 2, 35128, Padova, Italy
  3. Department of Medicine DIMED, University of Padova, Padova, Italy
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Otorhinolaryngology
  Neurosurgery
  Head and Neck Surgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1434-4726

文摘

Total laryngectomy (TL) is often still recommended as a salvage approach for recurrent laryngeal squamous cell carcinoma (LSCC). Considering LSCC recurrences after the failure of primary transoral laser microsurgery (TLM), open partial horizontal laryngectomy (OPHL) could be a valid alternative to TL in selected patients. The aim of the present study was to analyze retrospectively the oncological outcome of a consecutive series of 17 patients treated at the Otolaryngology Unit of Vittorio Veneto Hospital (Italy) with OPHL after primary TLM had failed. Nine patients (53 %) had no further recurrences after salvage OPHL. Eight patients had a second recurrence of LSCC after OPHL, and five of them were cured by further salvage treatment, while the other three died of their disease. We found an overall and disease-specific survival both of 82 % and a loco-regional control rate and an ultimate organ preservation rate of 82 and 70 %, respectively. Patients who underwent two-stage bilateral cordectomy for primary glottic carcinoma showed a trend towards a higher rate of second recurrences, a lower ultimate organ preservation rate and a shorter disease-free survival after salvage OPHL. Further studies on larger cohorts of patients are needed to identify potential clinical and/or pathological prognostic parameters capable of pinpointing patients at higher risk of second recurrences after salvage OPHL in cases where TLM has failed. A salvage TL might be reasonably proposed as a first salvage choice in such cases.