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A Critical Analysis

Dennis R. Maceri, MD; Howard B. Lampe, MD; Kathleen H. Makielski, MD; Peter P. Passamani, MD; Charles J. Krause, MD

Arch Otolaryngol. 1985;111(6):361-365.

Abstract
• Three hundred forty-two cases of laryngeal cancer were treated at the University of Michigan, Ann Arbor. One hundred ten supraglottic cancers and 150 glottic cancers were studied in depth. Conservation surgery was performed on 63 patients. Determinate two-year disease-free survival for glottic cancer was 90% in those irradiated primarily, 83% for those treated with vertical hemilaryngectomy, and 58% in the group that had total laryngectomy. Supraglottic cancers had a determinate survival rate at two years of 62% for those irradiated primarily, 80% for those treated with a supraglottic laryngectomy, and 62% when total laryngectomy was required. The cost of preserving the respiratory and sphincteric functions of the larynx in some cases amounted to the morbidity associated with a protracted hospital stay, altered deglutition, instances of a weak but functional voice, and the possibility of a permanent tracheostomy. Despite high recurrence rates of 30% to 40%, the overall determinate survival with salvage was an acceptable 80% for the conservation surgery group.

(Arch Otolaryngol 1985;111:361-365)

Author Affiliations
From the Department of Otolaryngology—Head and Neck Surgery, University of Michigan, Ann Arbor. Dr Maceri is now with the University of Southern California, Los Angeles.

Footnotes
Accepted for publication Dec 12, 1984.

Read before the American Society for Head and Neck Surgery, Palm Beach, Fla, May 9, 1984.

Reprint requests to Department of Otolaryngology, University of Southern California School of Medicine, 1200 N State St, Box 795, Los Angeles, CA 90033 (Dr Maceri).

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