The rates of SPMADT after treatment of SCCOC and SCCL are comparable, but the patterns are different. Smoking and alcohol use are independent predictors of SPMADT development.

To report the outcome of surgical salvage performed for early-stage squamous cell carcinoma of the glottic larynx that recurred or progressed after definitive radiotherapy. Design: Retrospective outcome analysis. Setting: Tertiary referral center specializing in head and neck cancer. Patients: Forty-three patients who underwent salvage surgery after definitive radiation therapy for early-stage (T1-T2) glottic cancer were identified from a preexisting database of 662 patients with squamous cell carcinoma of the larynx treated at Memorial Sloan-Kettering Cancer Center between the years 1984 and 1998. The T stage at initial presentation was T1 in 20 (18%) and T2 in 23 (32%). Twenty-one patients (49%) were amenable to salvage partial laryngectomy (SPL), but 22 (51%) required salvage total laryngectomy (STL). Details on patient characteristics, tumor characteristics, postoperative complications, and survival outcome were extracted from the database. Main Outcome Measures: Overall survival, diseasespecific survival, neck recurrence-free survival, and distant recurrence-free survival. Results: No postoperative death occurred following salvage surgery. The overall incidence of complications was 21%, with no difference between the SPL and STL groups. Patients who required STL had poorer overall survival and disease-specific survival compared with patients who required SPL (overall survival, 50% vs 89%; P=.003; disease-specific survival, 51% vs 93%; P=.002). This difference in survival was associated with a poorer neck recurrence-free survival and distant recurrence-free survival in the STL group compared with the SPL group (neck recurrence-free survival, 80% vs 100%; P =.04; distant recurrence-free survival, 71% vs 93%; P=.06). Univariate analysis showed that age and clinical T stage at recurrence were predictors of overall survival, diseasespecific survival, and distant recurrence-free survival.

Regardless of the index treatment modality, primary tumor site, or T stage, a higher clinical N stage at the time of presentation independently and significantly increases the risk of DM in patients with SCCL.

Successful replantations can achieve the best esthetic and functional results compared with other procedures. Scalp amputations sustained from sharp cuts seem to be quite as common as hair traction injuries. Such amputation injuries were more common in male patients with short hair. The manner of injury often will influence planning during replantation. Even if the amputated scalp was crushed or contaminated, such as those sustained from animal bites, replantation should still proceed, unless a greater contraindication exists.