Title:
Salvage surgery after unsuccessful radiotherapy in early glottic cancer
Authors:
R. Santoro , B. Bini , G. Mannelli , G. Meccariello , F. Paiar and O. Gallo
Institutions:
1First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence,Department of Radiotherapy, University of Florence, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
Keywords:
Salvage; surgery; radiotherapy failure; glottic; cancer
Pages:
113 - 120
Abstract:
Salvage surgery after unsuccessful radiotherapy in early glottic cancer. Surgery is the main therapeutic option to control recurrent laryngeal cancer after radiotherapy (RT) relapse. Most RT-recurred cancer is treated aggressively; although, conservative laryngeal surgery was attempted in selected cases. Here, we report our experiences with salvage laryngeal surgery for early glottic cancers that did not respond to RT. We analyzed files from 1980 to 2006 and selected 173 patients surgically treated for a RT-failed early glottic carcinoma (stage I-II according to 2010 TNM: 114 T1N0, 59 T2N0). Among them, 47 patients (27%) underwent a salvage partial laryngectomy (SPL) and 126 (73%) had a salvage total laryngectomy (STL). When compared with initial T staging, we found 61% of lesions were up-staged, 31% had the same staged lesion, and only 8% were down-staged (according to rTNM). No statistically significant differences were found in terms of disease-free survival and overall survival when SPL and STL patients were compared. Univariate analysis showed that T, rT, and rTNM were prognostic factors for overall survival (p=0.045, p=0.028, and p=0.037, respectively); yet, these significances were lost in multivariate analysis. Our results suggest that salvage surgery is feasible in most cases of RT-recurred early glottic cancer; although, a conservative approach achieves good oncological and functional results only in select RT-recurred patients.
Issue:
Vol. 10, 2014, 2nd trimester


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Salvage surgery after unsuccessful radiotherapy in early glottic cancer