Carbon Dioxide Laser Salvage Surgery after Radiotherapy Failure in T1 and T2 Glottic Carcinoma

Abstract

The present series indicates that selected recurrences after primary RT for T1 and T2 glottic carcinoma are eligible for endoscopic salvage surgery with oncologic results comparable to those with open neck procedures but with a lower complication rate and a favorable functional outcome.

Supracricoid partial laryngectomies after radiation failure: A multi‐institutional series

“…[1][2][3] Local recurrence rate after radiation therapy (RT) ranges from 5% to 13% for T1 and from 25% to 30% for T2 laryngeal cancer. 4,5 Surgical management of recurrences after RT failure encompasses endoscopic laser excision, [6][7][8] partial laryngectomies through an open-neck approach, 4,[9][10][11][12][13] and total laryngectomy, which still remains the most widely used procedure in such a scenario.…”

Salvage Transoral Laser Microsurgery for Radiorecurrent Laryngeal Cancer: Indications, Limits, and Outcomes

“…The series of Puxeddu et al [15] is a two-center retrospective case series, with results of one included center updated in a later publication by Piazza et al [16], which, in turn, was updated by Del Bon et al [17]. Most authors reported on series of rT1 to rT2 glottic cancer, while some authors also included more advanced glottic cases (rT3 or even rT4) [11••, 18–21] or supraglottic recurrences [14, 18, 20–22].…”

“…Most authors noticed higher rates of the development of a second recurrence following salvage TLM in patients with AC involvement when compared to patients with the AC free of tumor: second recurrence rates of 50 versus 11% [18], 71 versus 48% [23], 67 versus 8% [15], and 55 versus 29% [24], respectively, were reported. On univariate analysis, Han et al identified AC involvement as a negative prognostic factor for 3-and 5-year local control rates (51.9 versus 85.7% and 0 versus 64.2%, p  = 0.09) [24].…”

Transcervical Conservation Laryngeal Surgery

“…1,4 This subsequently makes the cricothyroid membrane and anterior commissure ligament more susceptible to direct extension of tumor.…”

“…The mainstay surgical treatment option for most early lesions is typically via a transoral approach, with shorter hospitalizations, lower morbidity, and improved functional results. 1 However, this review will focus on transcervical approaches and discuss their seminal anatomic principles. Open approaches can be considered in situations where exposure is inadequate for transoral resection, or the transoral technique is not in the purview of the institution, as well as for salvage surgery after radiation failure.…”