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Salvage surgery after radiotherapy failure in T1–T2 squamous cell carcinoma of the glottic larynx

✍ Scribed by Mark P. McLaughlin; James T. Parsons; Douglas A. Fein; Scott P. Stringer; Nicholas J. Cassisi; William M. Mendenhall; Rodney R. Million

Publisher
John Wiley and Sons
Year
1996
Tongue
English
Weight
685 KB
Volume
18
Category
Article
ISSN
1043-3074

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✦ Synopsis

Background. This study was undertaken to analyze the clinical course of patients who developed local (primary) recurrence after high-dose irradiation of T1 -T2 squamous cell carcinoma of the glottic larynx.

Methods. Between May 1977 and December 1989, 247 patients with previously untreated T1 and T2 invasive squamous cell carcinoma of the glottic larynx were treated for curative intent with radiotherapy. Local recurrence occurred in 26 of 247 patients (1 lYo), Successful surgical salvage was defined as no evidence of recurrent cancer for at least 2 years after salvage surgery and continuously thereafter.

Results. Two patients refused to undergo salvage surgery and one patient had unresectable disease. Of 23 patients who underwent salvage surgery, 19 had a total laryngectomy and 4 had a voice-sparing procedure. One patient who was continuously free of disease, died less than 24 months after salvage surgery; this patient was excluded from all local control and survival analyses, leaving 22 patients available for analysis. Successful salvage was achieved initially in 13 (59%) of the 22 patients. Two patients with local failure after voice-sparing salvage surgery underwent completion laryngectomy; one was salvaged, so that 14 of 22 (64%) were ultimately salvaged. The rate of successful salvage did not correlate with preirradiation T stage, time to failure after irradiation, or time from clinical suspicion of recurrence to histo-From the Departments of Radiation Oncology (Drs. McLaughlin, Parsons,

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