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Near-Total Laryngectomy for Laryngeal Carcinomas With Subglottic Extension
Ismet Aslan, MD;
Nermin Baserer, MD;
Engin Yazicioglu, MD;
Cagatay Oysu, MD;
Mehmet Tinaz, MD;
Erkan Kiyak, MD;
Necdet Biliciler, MD
Arch Otolaryngol Head Neck Surg. 2002;128:177-180.
Objective To investigate whether Pearson classic near-total laryngectomy is a
sensible surgical treatment modality for laryngeal carcinomas with subglottic
extension.
Design Retrospective analysis of patients treated by near-total laryngectomy
in a university hospital that is an academic tertiary health care center.
Participants and Intervention Medical and computer records of 135 patients who were treated by near-total
laryngectomy for laryngeal and hypopharyngeal carcinomas between April 1,
1989, and June 30, 2000, were searched thoroughly, and the final outcomes
were confirmed by telephone contact.
Main Outcome Measures Survival rates of the patients with laryngeal carcinomas with subglottic
extension treated by near-total laryngectomy were compared with those of the
patients with malignancies of other laryngeal regions given the same treatment.
Results Of the 135 patients in the study, 74 were available for determination
of 5-year survival. The rate was 65.8% (27/41) for transglottic tumors, 53.8%
(7/13) for supraglottic tumors, and 20.0% (4/20) for tumors with subglottic
extension. Only 3 of 16 patients with laryngeal carcinomas with supraglottic
or transglottic localization died of local recurrence; the rest of the deaths
were from regional recurrence or distant metastasis. However, 6 of 13 patients
with subglottic extension died of local recurrence, 5 of peristomal recurrence,
and only 2 of distant metastasis.
Conclusions Success was directly related to adherence to precise indications in
cancer surgery. While near-total laryngectomy is an effective and reliable
treatment modality in laryngeal cancer surgery, its effectiveness in laryngeal
cancers with subglottic extension is debatable. These subglottic lesions should
be treated by total laryngectomy, which is a more radical surgery.
From the Departments of Otorhinolaryngology, Faculty of Medicine, Istanbul
University (Drs Aslan, Baserer, Yazicioglu, Tinaz, Kiyak, and Biliciler),
and Taksim State Hospital for Research and Education (Dr Oysu), Istanbul,
Turkey.
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Arch Otolaryngol Head Neck Surg. 2002;128(2):202-203.
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