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Partial Laryngectomy to Treat Early Glottic Cancer After Failure of Radiation Therapy
Makiko Toma, MD;
Ken-ichi Nibu, PhD;
Kazunari Nakao, MD;
Masaki Matsuzaki, MD;
Masato Mochiki, MD;
Tadashi Yuge, MD;
Atsuro Terahara, PhD;
Masashi Sugasawa, PhD
Arch Otolaryngol Head Neck Surg. 2002;128:909-912.
Objective To evaluate the role of partial laryngectomy to treat glottic cancer
after failure of radiation therapy.
Design A 12-year retrospective outcome analysis.
Setting University referral center.
Patients A total of 19 patients who underwent partial laryngectomy to treat glottic
cancer after failure of radiation therapy.
Results The follow-up period in this group ranged from 31 to 144 months. After
surgery, a laryngocutaneous fistula was observed in 4 cases, and flap necrosis
occurred in 2, but these complications were successfully managed. Maximum
phonation time after surgery ranged from 3 to 28 seconds (median phonation
time, 10.2 seconds). Of these 19 patients, 3 developed local recurrence. These
cases were successfully treated with total laryngectomy. A surgical margin
of less than 1 mm was found to be a significant risk factor for local recurrence
after partial laryngectomy.
Conclusions These results indicate that partial laryngectomy is a useful option
for the treatment of irradiation failure in the treatment of stage I and stage
II vocal cord carcinomas. However, careful follow-up is mandatory for patients
with a small surgical margin.
From the Departments of Otolaryngology–Head and Neck Surgery
(Drs Toma, Nibu, Nakao, Matsuzaki, Mochiki, Yuge, and Sugasawa) and Radiology
(Dr Terahara), Graduate School of Medicine, University of Tokyo; and the Department
of Otolaryngology, Kanto Medical Center (Dr Toma), Tokyo, Japan.
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