Salvage laryngectomy for unsuccessful larynx preservation therapy Journal Article
| Authors: | Kraus, D. H.; Harrison, L. B.; Zelefsky, M.; Spiro, R. H.; Bosl, G. J.; Pfister, D. G.; Strong, E. W.; Shah, J. P. |
| Article Title: | Salvage laryngectomy for unsuccessful larynx preservation therapy |
| Abstract: | From 1983 to 1991,31 patients underwent salvage laryngectomy for persistent or recurrent squamous carcinoma of the larynx (14), hypopharynx (15), or oropharynx (2) as part of a larynx preservation protocol. Laryngectomy was performed as a consequence of poor response to induction chemotherapy in 13 and for recurrent disease after completion of chemotherapy and irradiation in 18. Postoperative pharyngocutaneous fistula occurred in 39%, resulting in prolonged hospitalization. Local control was achieved in 68%, more often in patients with laryngeal as opposed to nonlaryngeal primaries (86% versus 53%; p = .05). The overall actuarial survival and disease-specific survival at 2 years were 32% and 38%, respectively. Disease-specific survival at 2 years was better in patients with laryngeal as compared to nonlaryngeal primaries (56% versus 24%; p = .02). There were no long-term survivors among the nonlaryngeal primary patients. In selected patients in whom larynx preservation failed, salvage laryngectomy was associated with acceptable local control and survival. Palliation was obtained in patients who were not cured by their laryngectomy. Future investigation will focus on identification of factors predicting complications and strategies to reduce the incidence and severity. © 1995, SAGE Publications. All rights reserved. |
| Keywords: | adult; cancer chemotherapy; cancer survival; clinical article; aged; disease-free survival; surgical technique; clinical feature; cancer recurrence; laryngectomy; larynx carcinoma; salvage therapy; squamous cell carcinoma; carcinoma, squamous cell; fistula; laryngeal neoplasms; cisplatin; conference paper; cancer radiotherapy; combined modality therapy; neoplasm recurrence, local; antineoplastic combined chemotherapy protocols; postoperative complication; sepsis; larynx cancer; salvage; oropharynx carcinoma; oropharyngeal neoplasms; hypopharynx carcinoma; hypopharyngeal neoplasms; middle age; larynx preservation; human; male; female; priority journal; support, non-u.s. gov't; support, u.s. gov't, p.h.s. |
| Journal Title: | Annals of Otology Rhinology and Laryngology |
| Volume: | 104 |
| Issue: | 12 |
| ISSN: | 0003-4894 |
| Publisher: | Annals Publ Co |
| Date Published: | 1995-12-01 |
| Start Page: | 936 |
| End Page: | 941 |
| Language: | English |
| DOI: | 10.1177/000348949510401204 |
| PUBMED: | 7492064 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 28 August 2018 -- Source: Scopus |
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