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- Title
Salvage total laryngectomy after external-beam radiotherapy: A 20-year experience.
- Authors
Sandulache, Vlad C.; Vandelaar, Laura J.; Skinner, Heath D.; Cata, Juan; Hutcheson, katherine; Fuller, Clifton David; Phan, Jack; Siddiqui, Zuhair; Lai, Stephen Y.; Weber, Randal S.; Zafereo, Mark E.
- Abstract
Background The purpose of this study was to present our evaluation of the clinical and functional outcomes after salvage total laryngectomy (STL). Methods We conducted a retrospective review of 218 patients who underwent STL between 1994 and 2014. Results Seventy percent of patients originally had T1 or T2, N0 tumors and 73% had definitive external-beam radiotherapy (EBRT) alone. A majority utilized tracheoesophageal prosthesis (77%) and were gastrostomy free (80%) at last follow-up. The 5-year disease control and overall survival (OS) rates were 65% and 57%, respectively. Patients with a disease-free interval after initial treatment <2 years were more likely to develop a recurrence ( p = .001) and die of disease ( p = .032) after STL. The disease-free interval after EBRT impacted disease control ( p < .001), with 5-year disease control of 92% for >5-year disease-free interval and 60% for <2-year disease-free interval. Conclusion Most patients remain disease-free after STL, achieve intelligible tracheoesophageal speech, and maintain an oral diet. Delayed recurrence after initial treatment portends better survival and may indicate a distinct biological profile. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1962-E1968, 2016
- Subjects
LARYNGECTOMY; CANCER radiotherapy research; CANCER treatment; SQUAMOUS cell carcinoma; CANCER relapse; PROGRESSION-free survival; FREE flaps
- Publication
Head & Neck, 2016, Vol 38, pE1962
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.24355