Evaluation of clinical outcomes after partial horizontal laryngectomy

Abstract

Introduction: The laryngeal squamous cell carcinoma (LSCC) is a prevalent disease, with 7670 cases estimated in Brazil during 2018-2019. The preferred treatment for early LSCC is either surgery or radiotherapy. Horizontal partial laryngectomy (HPL) is one of the forms of surgical treatment. Objective: Evaluate the oncological and functional outcomes of patients submitted to HPL for the treatment of LSCC. Methods: A retrospective descriptive study of patients submitted to HPL, performed at a cancer referral center, between January 2011 and December 2017. Results: We evaluated 37 patients. The major pathological staging of the primary tumor was pT3 (35.1%), followed by pT2 (32.4%). Five patients required adjuvant radiotherapy; 62.2% of the patients were decannulated by the end of the treatment; 10.8% weren`t decannulated; 8.1% underwent a retracheostomy, and 18.9% had total laryngectomy. From the patients submitted to total laryngectomy, 3 cases were due to rehabilitation failure, 2 due to recurrence and 2 cases due to postoperative suture dehiscence. About 89% of the patients resumed oral feeding following the procedure; 86.4% didn`t present disease recurrence; 31 patients survived without disease; 3 died from disease-related causes, and 3 from unrelated causes. Conclusion: HPL is an alternative procedure to total laryngectomy, presenting adequate rates of local control and overall survival while also maintaining laryngeal function. The main challenge to HPL remains achieving an ideal selection of patients.