Total Laryngectomy following Successful Chemoradiation Therapy for Advanced Laryngeal Carcinoma

Abstract

Objectives: 1) Describe the Loyola University Medical Center experience of total laryngectomies performed for a non-functional larynx following successful chemoradiation therapy for advanced laryngeal malignancies. 2) Recognize the impact surgical as well as non-surgical therapy has on head and neck cancer patients quality of life. Methods: A retrospective study was conducted using chart review to identify patients who underwent total laryngectomy between 2004 and 2012 at LUMC, an academic tertiary medical center. Patients that completed chemoradiation therapy and subsequently underwent total laryngectomy were identified and divided into two groups. The first group underwent total laryngectomy for a non-functional larynx and the second group underwent surgery for persistent or recurrent disease. Only patients with squamous cell carcinoma of the larynx were included in this study. Results: A total of 143 total laryngectomies were performed at LUMC between 2004-2012. Seven patients were identified that underwent total laryngectomy following successful chemoradiation. All seven patients were tracheostomy and/or gastrostomy tube dependent prior to their laryngectomy. This patient population accounted for approximately 5% of all total laryngectomies performed at LUMC since 2004. Conclusions: This study identifies a patient population not previously described in the literature: those who underwent successful chemoradiation for advanced laryngeal carcinomas but failed organ preservation therapy due to a non-functional larynx. These patients suffered a significant impact on their quality of life and underwent a surgery they initially strived to avoid.