Salvage laryngectomy for recurrent larynx cancer after nonsurgical treatment failure

Abstract

Objective: Analyze salvage total laryngectomy as treatment in recurrence after organ preserving strategy (QRT/RT), determine recurrence rates, survival and predictive factors.

Study design: Retrospective charts review.

Materials and methods: Salvage total laryngectomy patients, from 2005 to 2017. Univariate analysis with T Student, Mann Whitney, survival estimates with Kaplan-Meier method and Cox proportional hazards model.

Results and conclusions: 63 patients, 95,24% male, mean age 56,75<7,9 years. 12,7% supraglotic location, 71,2% glotic and 15,9% transglotic. Primary tumor T stage was 54% T1/T2, 46% T3, N stage 69,8% N0 and 30,2% N+. T1/T2 group had 91,2% 2-year survival rate vs 62,1% for T3 stage. For N0 2-year survival rate was 88,6% vs 52,6% for N+ patients, glotic tumors had a 2-year survival rate of 84,4% vs 61,1% for non-glotic. Total laryngectomy in salvage setting is safe and effective, primary T and N stage, tumor location and age were identified as predictive factors of survival.