Original scientific paper
Influential Factors, Complications and Survival Rate of Primary and Salvage Total Laryngectomy for Advanced Laryngeal Cancer
Milan Stanković
; University Clinical Center Niš, Clinic for Otorhinolaryngology, Niš, Serbia
Dušan Milisavljević
; University Clinical Center Niš, Clinic for Otorhinolaryngology, Niš, Serbia
Dragan Stojanov
; University Clinical Center Niš, Clinic for Otorhinolaryngology, Niš, Serbia
Miško Zivić
; University Clinical Center Niš, Clinic for Otorhinolaryngology, Niš, Serbia
Saša Zivaljević
; University Clinical Center Niš, Clinic for Otorhinolaryngology, Niš, Serbia
Ivona Stanković
; University of Niš, Medical Faculty, Niš, Serbia
Slađana Petrović
; University of Niš, Institute for radiology, Niš, Serbia
Abstract
This is a retrospective review of patients with advanced malignant neoplasms of the larynx treated with total laryngectomy. 387 total laryngectomies for advanced squamous cell carcinoma of larynx performed in the period between 1995 and 2007 were analyzed. Primary total laryngectomy (PRT) was performed in 316 patients, while initial radiotherapy radiotherapy (60–70 Gy) and concomitant chemotherapy (cisplatin-5 fluorouracil) with radiotherapy were applied in totally 71 patients who later received salvage total laryngectomy (STL). All the laryngectomies were performed by four surgeons, using the same routine surgical technique. Postoperative clinical examination was made every three months during five years. We documented the occurrence of: local and general complications, survival rate, residual and recurrent disease, lymph node metastasis, and other changes. Salvage total laryngectomy after previous radiotherapy (STL-pRT) and after chemoradiotherapy (STL-pCTRT) caused more frequent local complications than primary total laryngectomy (PTL). TNM stage and localization of primary laryngeal tumor had significant influence on five year survival rate. It
amounted: 61.4% for PTL, 52.6% for STL-pCTRT, and 48.5% for STL-pRT. Incomplete response to initial treatment produced low survival rate. Salvage total laryngectomy caused more frequent local complications, especially after chemoradiotherapy whan compared to primary laryngectomy. Survival rate was increased when chemotherapy is added to radiotherapy. Five year survival rate depended on TNM stage and localization of primary tumor.
Keywords
larynx; squamous cell carcinoma; total laryngectomy; five year survival; complications
Hrčak ID:
96440
URI
Publication date:
2.1.2013.
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