Abstract
Abstract The objective of this study was to investigate T4 laryngeal cancer patients with skin infiltration regarding survival and different variables that may influence the survival. This was a retrospective analytic study. This study included 14 patients suffering from laryngeal carcinoma, with tumor extending to involve the skin of the front of the neck. Total laryngectomy was performed for all patients together with excision of the overlying skin, and pectoralis major myocutaneous flap was used for reconstruction of the skin defect in all patients. Analysis of the preoperative, operative, postoperative, and follow-up patients’ data was performed. The 1-, 2-, 3-, and 5-year survival rates were estimated. The overall mean survival time for all patients was 51.1 ± 8.3 months. The mean survival time for patients with recurrent disease was 16.4 ± 3.5 months and for patients without recurrent disease was 70.7 ± 6 months. The 1-, 2-, 3-, and 5-year survival rates were 92.9, 71.4, 64.3, and 50%, respectively. The univariate analysis revealed that previous treatment before definitive surgery was the only variable that had a statistical influence on the overall 5-year survival rate (P = 0.046). Extended laryngectomy with skin removal offers reasonable 5-year survival rate for T4 laryngeal cancer patients with skin invasion, and reconstruction of the neck skin defect with a pectoralis major myocutaneous flap is a reliable method of repair.
Highlights
Laryngeal cancer usually spreads along the mucosal surface or by submucosal infiltration
Extended laryngectomy with skin removal offers reasonable 5-year survival rate for T4 laryngeal cancer patients with skin invasion, and reconstruction of the neck skin defect with a pectoralis major myocutaneous flap is a reliable method of repair
We reviewed 14 laryngeal cancer patients with neck skin invasion, who were managed surgically
Summary
Laryngeal cancer usually spreads along the mucosal surface or by submucosal infiltration. Fungation of laryngeal cancer through skin is a rare condition that requires extension of total laryngectomy to involve en-bloc resection of a wide area of skin of the front of the neck followed by reconstruction of the defect. The 5-year survival rate ranges between 53 and 84% with radiotherapy [2,3], whereas partial laryngectomy alone results in a 5-year survival rate of 86–100% [4]. We decided to investigate T4 laryngeal cancer with skin infiltration in terms of survival and the different variables that may influence survival in such cases, namely previous therapy, preoperative tracheostomy, exact tumor location, and the nodal stage. The use of PMMF for reconstruction of the resultant skin defect was evaluated in terms of complications such as wound gap and pharyngocutaneous fistula
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