Abstract
To evaluate the impact of the practice of a preoperative tracheotomy and different prognostic factors reported in the literature in patients with transglottic carcinoma of the larynx, a retrospective study was performed in the Instituto Nacional de Cancerologia, Mexico City. In all, 90 cases with T3 transglottic squamous cell carcinoma requiring a total laryngectomy as primary treatment were studied. Prognostic factors such as the Karnofsky index, tumor differentiation, surgical margins and preoperative tracheotomy were analyzed by a Cox’s proportional hazards model. The Kaplan-Meier method and log rank test were used to evaluate the disease-free intervals and survival curves. Thirty-two patients had preoperative tracheotomies, while 58 did not. Eighty percent of the patients in the non-preoperative tracheotomy group were alive after 5 years versus 20% of those with preoperative tracheotomies (P < 0.001). Although possibly controversial, our findings indicate that a pretreatment tracheotomy should be avoided in T3 transglottic obstructive lesions. In patients with these lesions and a subglottic extension ≤ 3 cm we recommend an emergency total laryngectomy when possible to increase survival and decrease surgical morbidity.
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Received: 1 April 1998 / Accepted 29 June 1998
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Carrillo, J., Frías-Mendívil, M., Lopez-Graniel, C. et al. The impact of preoperative tracheotomy on T3 transglottic carcinomas of the larynx. European Archives of Oto-Rhino-Laryngology 256, 78–82 (1999). https://doi.org/10.1007/s004050050120
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DOI: https://doi.org/10.1007/s004050050120