Supracricoid Partial Laryngectomy in the Treatment of Laryngeal Cancer

Abstract

Objectives: To evaluate the oncological results of supracricoid partial laryngectomy as a treatment for selected glottic and supraglottic cancer in a large series of patients who had undergone uniform treatment over a 16-year period and to determine the different prognostic factors that may influence local control and survival.Design: Retrospective clinical study.Setting: Academic tertiary referral medical center. Patients:The study population comprised 253 consecutive patients (234 men and 19 women) with glottic and supraglottic squamous cell carcinoma. The mean age was 58 years for men and 59.2 years for women.Intervention: Supracricoid partial laryngectomy: 180 patients had undergone cricohyoidopexy and 73 had undergone cricohyoidoepiglottopexy.Main Outcome Measures: Local control and overall survival. Potential prognostic factors for local control and survival were evaluated with univariate and multivariate models.Results: The 3-, 5-, 10-, and 16-year overall survival rates in this group of 253 patients were 85.8%, 79.1%, 57.6%, and 57.6%, respectively. With regard to local control, univariate and multivariate analyses showed that a positive resection margin was the only important predictor of local control and that a dysplastic lesion at the margin of resection is just as aggressive as the presence of invasive carcinoma. When considering the prognostic factors influencing survival, univariate analysis showed that the tumor category, lymph node category, tumor stage, and recurrence all had a significant influence on the survival rate. Multivariate analysis showed that the most important predictor of survival was recurrence.Conclusions: Supracricoid partial laryngectomy is a valid choice in the treatment of selected glottic and supraglottic cancer while maintaining laryngeal functions and achieving a high rate of local control. T category, N category, tumor stage, positive resection margins, and recurrence are the most important predictors of oncological outcome.

Supracricoid laryngectomy with cricohyoidopexy: oncological results

“…In this group, the 3-and 5-year survival rates were 80-93.5 and 66.5-95.6%, respectively [1,2,[16][17][18][19][20][21][22].…”

Conservative treatment for advanced T3–T4 laryngeal cancer: meta-analysis of key oncological outcomes

“…Adjuvant radiotherapy (RT) was not systematically administered by authors to every patient to avoid its potential collateral effects on their functional outcomes [31,39]. The presence of positive resection margins after open partial surgery or patients with persistent tumour after transoral margins re-resection, large extra-laryngeal tumour extent, pathological report with presence of perineurial invasion and angioembolization, multiple positive lymph nodes and/or neck nodes with extra capsular spread (ECS) of the disease, represented the main conditions for adjuvant RT treatment indication.…”

“…On the other hand, since Piquet and Chavalier [57] supracricoid laryngectomy has gained international acceptance, ensuring a reproducible and shared 5-year overall survival rate for all stages between 75 and 95% [26,29,31,33,40,58], together with a preservation successful rate in about 80% of cases [59,60].…”

Laryngeal function preservation following supracricoid partial laryngectomy

“…Several reports in the literature show local control and survival rates similar to those obtained with total laryngectomy. [1][2][3] The procedure allows the preservation of laryngeal functions in selected locally early and FIGURE 1. Number of days with tracheostomy and enteral nutrition.…”