Function preserving laryngeal cancer surgery in Hungary-- a historical retrospect and 25 years personal experiences

Abstract

The continuity in the trends in conservation and surgery in the Hungarian laryngology are emphasized. The first Hungarian book on this topic, "Diseases of the Larynx" by Navratil, was published 127 years ago ("A gégebajok", Pest, 1866). Onodi popularized the laryngectomy and the results of the surgery of laryngeal carcinoma in the first two decades. In 1900, Herczel described on a vertical partial laryngectomy. Lénárt was an internationally accepted Hungarian surgeon in laryngology whose results (cordectomy 61%, partial laryngectomy 48%, hemilaryngectomy 42%, total laryngectomy 35%) were consistently successful. Réthi was a famous name in the recent period of Hungarian laryngeal surgery for laryngotracheal stenosis and laryngeal carcinoma. In the past 25 years, the occurrence of supraglottic cancer was the highest. The author reports his personal results and stresses the importance of conservation surgery. Of a total of 643 patients with supraglottic carcinoma, 126 (20%) were treated by primary radiotherapy, 169 (26%) were operated on by total laryngectomy, 245 (38%) by supraglottic laryngectomy, 61 (9.5%) by supraglottic subtotal laryngectomy (personal method) and 42 (6.5%) by resection of the supraglottic larynx and the base of the tongue. Local tumour control was constantly good with a local recurrence rate of 6.6%. The 5-year survival rate was 74.3% for supraglottic laryngectomy, 68.9% for subtotal laryngectomy and 62% for the resection of the supraglottic larynx and the base of the tongue group.