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Xavier Dufour, MD; Stéphane Hans, MD; Erwan De Mones, MD; Daniel Brasnu, MD; Madeleine Ménard, MD; Ollivier Laccourreye, MD

Arch Otolaryngol Head Neck Surg. 2004;130:1092-1099.

Objectives  To determine the incidence of local control in patients with "advanced" moderately to well-differentiated endolaryngeal invasive squamous cell carcinoma classified as T3, treated with a supracricoid partial laryngectomy; to identify any statistical relationship; and to analyze the consequences of local recurrence.

Design  Retrospective nonrandomized case series.

Setting  A tertiary referral care center and university teaching hospital.

Patients  An inception cohort of 118 patients. Tumor stage was T3 N0 M0 in 90 patients, T3 N1 M0 in 21 patients, T3 N2 M0 in 5 patients, and T3 N3 M0 in 2 patients.

Interventions  All patients underwent supracricoid partial laryngectomy. A platin-based induction chemotherapy regimen was used in 100 patients. Postoperative radiotherapy was used for 24 patients.

Main Outcome Measures  Local recurrence, nodal recurrence, distant metastasis, and survival; univariate and multivariate analysis of local recurrence.

Results  Nine patients developed a local recurrence. The 1-, 3-, and 5-year actuarial local control estimates were 97.3%, 93.5%, and 91.4%, respectively. In a stepwise regression model, the presence of positive margins of resection was the only variable that statistically increased the risk of local recurrence (P = .008). Local recurrence resulted in a significant increase in nodal recurrence (P<.001) and distant metastasis (P<.001) and a significant decrease in survival (P = .03). An overall 89.8% laryngeal preservation rate and 98.3% local control rate were achieved.

Conclusion  Supracricoid partial laryngectomies should be considered when an organ preservation strategy is discussed in patients with advanced endolaryngeal squamous cell carcinoma classified as T3.

From the Department of Otorhinolaryngology–Head and Neck Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, University of Paris V, Paris, France. Dr Dufour is now with the Department of Otorhinolaryngology–Head and Neck Surgery, Centre Hospitalo-universitaire, Poitiers, France. The authors have no relevant financial interest in this article.

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