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Supratracheal laryngectomy: a multi-institutional study.

Abstract：

INTRODUCTION:Supratracheal laryngectomy has been described as a surgical procedure for glottic or supraglottic cancer extending to the subglottic region and/or involving the cricoarytenoid joint, aiming to preserve laryngeal function (breathing, phonation and swallowing), without diminishing locoregional cancer control. The choice of supracricoid laryngectomy in these cases could result in a high risk of compromised resection margins. OBJECTIVE:To determine the safety, viability, adequacy of surgical margins and the supratracheal laryngectomy results for intermediate and advanced laryngeal cancer by reviewing the results at three different institutions in Brazil. METHODS:This is a retrospective study that analyzed the charts of 29 patients submitted to supratracheal laryngectomy from October 1997 to June 2017. The type of laryngectomy performed was classified according to the European Laryngological Society classification for horizontal laryngectomies. Early and late results were evaluated. Survival rates (overall, specific, disease-free and total laryngectomy-free survival) were calculated. The mean follow-up time was 44 months. RESULTS:Of the 29 patients submitted to supratracheal laryngectomy, 25 had no previous treatment. One patient (3.4%) had compromised margins. Four patients (13.8%) had recurrence. Of these, three had local recurrence and one had regional recurrence. Five patients (17.2%) required a total laryngectomy, two due to ruptured pexy and three due to local recurrence. Four of these patients (80%) achieved a successful total procedure. Four patients (13.8%) died, two due to postoperative complications and two due to recurrence. Overall, specific, disease-free and total laryngectomy-free survival at 5 years were, respectively, 82.1%; 88.2%; 83.0% and 80.2%. CONCLUSION:Selected patients with intermediate and advanced laryngeal cancer may benefit from supratracheal laryngectomy, that resulted in total laryngectomy-free survival and specific survival of 80.2% and 88.2%, respectively.

journal_name

Braz J Otorhinolaryngol

journal_title

Brazilian journal of otorhinolaryngology

authors

Garcia AM,Dias FL,Gonçalves AJ,Cernea CR,Freitas EQ,Menezes MB,Kulcsar MAV

doi

10.1016/j.bjorl.2019.04.004

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

609-616

issue

eissn

1808-8694

issn

1808-8686

pii

S1808-8694(18)30703-1

journal_volume

pub_type

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Supratracheal laryngectomy: a multi-institutional study.