Supracricoid partial laryngectomy with cricohyoidoepiglottopexy in patients with radiation therapy failure
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BioMed Central
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Supracricoid partial laryngectomy with cricohyoidoepiglottopexy in patients with radiation therapy failure Kuauhyama Luna-Ortiz*1,2, Philippe Pasche3, Mario Tamez-Velarde1 and Veronica Villavicencio-Valencia1 Address: 1Department of Head and Neck Surgery, Instituto Nacional de Cancerología (Mexico), Av. San Fernando #22, Tlalpan, Mexico, D.F., 14080, Mexico, 2Universidad Nacional Autonoma de México (UNAM), Mexico, D.F., Mexico and 3Service dÒRL, Centre Hospitalier Universitaire Vaudios, Lausanne, Switzerland Email: Kuauhyama Luna-Ortiz* - [email protected]; Philippe Pasche - [email protected]; Mario TamezVelarde - [email protected]; Veronica Villavicencio-Valencia - [email protected] * Corresponding author
Published: 19 December 2009 World Journal of Surgical Oncology 2009, 7:101
doi:10.1186/1477-7819-7-101
Received: 27 April 2009 Accepted: 19 December 2009
This article is available from: http://www.wjso.com/content/7/1/101 © 2009 Luna-Ortiz et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: To assess functional results, complications, and success of larynx preservation in patients with recurrent squamous cell carcinoma after radiotherapy. Methods: From a database of 40 patients who underwent supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) from June 2001 to April 2006, eight patients were treated previously with radiotherapy due to squamous cell carcinoma of the glottic region and were treated for recurrence at the site of the primary cancer. Results: SCPL with CHEP was performed in six men and two women with a mean age of 67 years due to recurrence and/or persistence at a mean time of 30 months postradiotherapy (in case #8 after concomitant chemoradiotherapy). Bilateral neck dissection at levels II-V was performed in six patients. Only case #8 presented metastasis in one node. In case #5, Delphian node was positive. It was possible to preserve both arytenoids in five cases. Definitive surgical margins were negative. Complications were encountered in seven patients. Follow-up was on average 44 months (range: 20-67 months). Organ preservation in this series was 75%, and local control was 87%. Overall 5year survival was 50%. Conclusions: In selected patient with persistence and/or recurrence after radiotherapy due to cancer of the larynx, SCPL with CHEP seems to be feasible with acceptable local control and toxicity. Complications may occur as in previously non-irradiated patients. These complications must be treated conservatively to avoid altering laryngeal function.
Introduction Primary radiotherapy as treatment for early cancer of the glottis has been the most used treatment modality due to its low morbidity and excellent prognosis [1,2]. Rate
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