Is Salvage Vertical Partial Laryngectomy Safe in Patients with Radiation-Failure Carcinoma of the Glottic Larynx?

Korean Journal of Head & Neck Oncology 2003;19(1):16-20.
Published online May 30, 2003.

Young Chang Lim;Jeong Taek Lim;Joo Wan Kang;Hyun Seung Choi;Mee Hyun Song;Min Byum Kim;Eun Chang Choi

방사선치료 실패 후의 수직부분후두절제술은 안전한가?

임영창;임정택;강주완;최현승;송미현;김민범;최은창

Abstract

Objectives: Radiotherapy is an effective treatment in the initial management of T1 glottic carcinoma, but local recurrent or residual tumor growth is found in approximately 10% of the patients. Even in recurrence or residual tumor, in highly selected cases, conservation surgery with preservation of a portion of the larynx is feasible. So we investigated the efficacy of salvage vertical partial laryngectomy for recurrent glottic carcinoma after irradiation. Material and Methods: Retrospectively we reviewed a consecutive series of 10 patients treated by conservative vertical partial laryngectomy of the larynx for radiation-failure, recurrent T1 glottic squamous cell carcinoma treated at Severance Hospital from 1994 to 2002.
Results
Local recurrence developed in 4 patients (40%). Two patient was salvaged by further totallaryngectomy. Successful salvage was achieved finally in 8 (80%) of the 10 patients. There was no operative mortality. Postoperative perichondritis was developed in two patients. One was resolved by conservative treatment, but the other has underwent the total laryngectomy.
Conclusion
A vertical partial laryngectomy in case of recurrent glottic carcinoma after a course of irridation should be the therapy of choice when stringent criteria are observed.

Key Words: Radiation failure, Early glottic carcinoma, Salvage vertical partial laryngectomy