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Subtotal laryngectomy: outcomes of 469 patients and proposal of a comprehensive and simplified classification of surgical procedures

  • Laryngology
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Abstract

Long-term oncological and functional results from a retrospective study on 469 patients over a 10-year period of subtotal laryngectomies (SL), 399 supracricoid partial laryngectomies (SCL) and 70 supratracheal partial laryngectomies (STL) are presented. The mean follow-up time was 97 months (range 60–165 months). Acute complications, types and rates of late sequelae, functional results, 2-year post-operative scores of laryngeal function and quality of life are reported. The observed long-term results were: SCL, 5-year overall and disease-free survival: 95.6, and 90.9%, respectively; 2-year post-operative laryngeal function preservation: 95.7%; STL, 5-year overall and disease-free survival: 80 and 72.9%, respectively; 2-year post-operative laryngeal function preservation: 80%. The performance status scale for laryngeal function preservation showed very high 2-year scores, with no significant differences depending on the type and extent of surgery. The adopted type of function-sparing surgery provided overall and disease-free survival rates that were somewhat better than those reported in studies based on organ-sparing protocols with chemoradiotherapy. The rate of total laryngectomy of completion in this series was 4.4%. A new classification of the current horizontal partial laryngectomies is also proposed, namely “Horizontal Laryngectomy System” (HOLS), based on the extent of surgical removal of laryngeal structures.

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References

  1. Ferlay J, Parkin DM, Steliarova-Foucher E (2010) Estimates of cancer incidence and mortality in Europe in 2008. Eur J Cancer 46:765–781

    Article  PubMed  CAS  Google Scholar 

  2. Serafini I (1972) Reconstructive laryngectomy. Rev Laryngol Otol Rhinol 93:23–32

    CAS  Google Scholar 

  3. Laudadio P, Presutti L, Dall’Olio D, Cunsolo E, Consalici R, Amorosa L, Cancellieri A, Bocciolini C (2006) Supracricoid laryngectomies: long-term oncological and functional results. Acta Otolaryngol 126(6):640–649

    Article  PubMed  Google Scholar 

  4. Laccourreye O, Brasnu D, Biacabe B, Hans S, Seckin S, Weinstein G (1998) Neo-adjuvant chemotherapy and supracricoid partial laryngectomy with cricohyoidopexy for advance endolaryngeal carcinoma classified as T3–T4: 5-year oncologic results. Head Neck 20:595–599

    Article  PubMed  CAS  Google Scholar 

  5. De Vincentiis M, Minni A, Gallo A, Di Nardo A (1998) Supracricoid partial laryngectomies: oncologic and functional results. Head Neck 20(6):504–509

    Article  PubMed  Google Scholar 

  6. Piquet JJ, Desaulty A, Decroix G (1974) La Crico-hyoido-épiglotto-pexie. Tecnique opératoire et résultats fonctionnels. Ann Otolaryngol Chir Cervicofac 91:681–690

    PubMed  CAS  Google Scholar 

  7. Labayle S, Bismuth R (1971) La laryngectomie totale avec reconstruction. Ann Otol-laryngol 88:219–228

    CAS  Google Scholar 

  8. Rizzotto G, Succo G, Lucioni M, Pazzaia T (2006) Subtotal laryngectomy with tracheohyoidopexy: a possible alternative to total laryngectomy. Laryngoscope 116:1907–1917

    Article  PubMed  Google Scholar 

  9. Union International Contre le Cancer (2002) TNM classification of malignant tumors, 6th edn. Wiley-Liss, New York

    Google Scholar 

  10. Karnofsky DA, Burchenal JH (1949) The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM (ed) Evaluation of chemotherapeutic agents. Columbia University Press, New York, pp 199–205

    Google Scholar 

  11. Robbins KT, Clayman G, Levine PA, Medina J, Sessions R, Shaha A, Som P, Wolf GT (2002) Neck dissection classification update: revisions proposed by the American Head and Neck Society and the American Academy of Otolaryngology-Head and Neck Surgery. American Head and Neck Society; American Academy of Otolaryngology—Head and Neck Surgery. Arch Otolaryngol Head Neck Surg 128(7):751–758

    PubMed  Google Scholar 

  12. Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefèbvre J, Greiner RH et al (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350(19):1945–1952

    Article  PubMed  CAS  Google Scholar 

  13. Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB et al (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350(19):1937–1944

    Article  PubMed  Google Scholar 

  14. List MA, Ritter-Sterr C, Lansky SB (1990) A Performance Status Scale for head and neck cancer patients. Cancer 66:564–569

    Article  PubMed  CAS  Google Scholar 

  15. Weir NF (1973) Theodore Billroth: the first laryngectomy for cancer. J Laryngol Otol 87:1162–1170

    Article  Google Scholar 

  16. McLaughlin MP, Parsons JT, Fein DA, Stringer SP, Cassisi NJ, Mendenhall WM, Million RR (1996) Salvage surgery after radiotherapy failure in T1–T2 squamous cell carcinoma of the glottis larynx. Head Neck 18(3):229–235

    Article  PubMed  CAS  Google Scholar 

  17. Peretti G, Piazza C, Ansarin M, De Benedetto L, Cocco D, Cattaneo A, Nicolai P, Chiesa F (2010) Transoral CO2 laser microsurgery for Tis-T3 supraglottic squamous cell carcinomas. Eur Arch Otolaryngol 267(11):1735–1742

    Article  Google Scholar 

  18. Ambrosch P (2007) The role of laser microsurgery in the treatment of laryngeal cancer. Curr Opin Otolaryngol Head Neck Surg 15(2):82–88

    Article  PubMed  Google Scholar 

  19. Steiner W, Ambrosch P, Rodel RM, Kron M (2004) Impact of anterior commissure involvement on local control of early glottis carcinoma treated by laser microresection. Laryngoscope 114(8):1485–1491

    Article  PubMed  Google Scholar 

  20. Lefebvre JL, Ang KK et al (2009) Larynx preservation clinical trial design: key issues and recommendations—a consensus panel summary. Head Neck 31:429–441

    Article  PubMed  Google Scholar 

  21. Peretti G, Piazza C, Mensi MC, Magnoni L, Bolzoni A (2005) Endoscopic treatment of cT2 glottic carcinoma: prognostic impact of different pT subcategories. Ann Otol Rhinol Laryngol 114(8):579–586

    PubMed  Google Scholar 

  22. de Bree R, Leemans R, Silver CE et al (2011) Paratracheal lymph node dissection in cancer of the larynx, hypopharynx and cervical esophagus: the need of guidelines. Head Neck 33:912–916

    Article  PubMed  Google Scholar 

  23. Benito J, Holsinger FC, Perez-Martin A et al (2011) Aspiration after supracricoid partial laryngectomy: incidence, risk factors, management and outcomes. Head Neck 33:679–685

    Article  PubMed  Google Scholar 

  24. Spriano G, Pellini R, Romano G, Muscatello L, Roselli R (2002) Supracricoid partial laryngectomy as salvage surgery after radiation failure. Head Neck 24:759–765

    Article  PubMed  Google Scholar 

  25. Weinstein SG, Myers EN, Shapshay SM (2004) Nonsurgical treatment of laryngeal cancer. N Eng J Med 350:1049

    Article  CAS  Google Scholar 

  26. Hoffman HT, Porter K, Karnell LH, Cooper JS, Weber RS, Langer CJ, Ang KK, Gay G, Stewart A, Robinson RA (2006) Laryngeal cancer in the United States: changes in demographics, patterns of care, and survival. Laryngoscope 116(9 Pt 2 Suppl 111):1–13

    Article  PubMed  Google Scholar 

  27. Remacle M, Eckel HE, Antonelli AR, Brasnu D, Chevalier D, Friedrich G, Olofsson J, Rudert HH, Thumfart W, de Vincentiis M, Wustrow TP (2000) Endoscopic cordectomy. A proposal for a classification by the Working Committee, European Laryngological Society. Eur Arch Otorhinolaryngol 257(4):227–231

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This paper is dedicated to the memory of Professor Italo Serafini, a pioneer and teacher in the field of laryngeal surgery. A sincere appreciation to Professor A.R. Antonelli for his precious advice and suggestions.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy

    G. Rizzotto & M. Lucioni

  2. Department of Otorhinolaryngology, Ospedale Martini, Turin, Italy

    E. Crosetti & G. Succo

  3. ENT Department, Ospedale Martini, Via Tofane 71, 10141, Torino, Italy

    G. Succo

Authors
  1. G. Rizzotto
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  2. E. Crosetti
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  3. M. Lucioni
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  4. G. Succo
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Correspondence to G. Succo.

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Rizzotto, G., Crosetti, E., Lucioni, M. et al. Subtotal laryngectomy: outcomes of 469 patients and proposal of a comprehensive and simplified classification of surgical procedures. Eur Arch Otorhinolaryngol 269, 1635–1646 (2012). https://doi.org/10.1007/s00405-012-1928-4

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  • DOI: https://doi.org/10.1007/s00405-012-1928-4

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