Salvage Surgery for Early Glottic Carcinoma (Stage I·II) After Failure of Radiotherapy

Abstract

Of 536 patients who were treated by radical radiotherapy for early (stage I·II) glottic squamous carcinoma between 1979 and 1994, 97 patients failed locally. Seventy-seven per cent of the recurrent lesions were detected within 2 years. Partial laryngectomy for salvage was performed in 39 patients ; 34 of 58 in Tla, 0 of 8 in Tlb and 5 of 31 in T2, respectively. The cumulative 5-year survival rate calculated from the beginning of irradiation in 97 patients was 85.3 %, which was similar to the rate of the remaining patients controlled by irradiation. The cumulative 5-year survival rates and the cause-specific 5-year survival rates estimated from the date of salvage surgery were 85.5%, 94.0% in patients with partial laryngectomy and those were 76.1%, 97.7 % in those with total laryngectomy, respectively. The acutual laryngeal preservation rates were 82% (32139) in partial laryngectomiees and 33% (32197) overall. It showed partial laryngectomy was effective after failure of radiationtherapy, so it was found to be important to recognize the recurrent tumors as soon as possible.