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Oncologic Outcomes After Salvage Laryngectomy for Squamous Cell Carcinoma of the Larynx and Hypopharynx: A Multicenter Retrospective Cohort Study

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

We aimed to analyze oncologic outcomes and identify patterns of failure and negative prognostic factors in patients who underwent salvage total laryngectomy (STL) for residual, recurrent, and second primary squamous cell carcinoma (SCC) of the larynx and hypopharynx.

Methods

This was a retrospective cohort study of patients who underwent STL in four major Belgian reference hospitals between 2002 and 2018 for residual/recurrent/second primary SCC in the larynx or hypopharynx after initial (chemo)radiation. Prognostic factors for oncologic outcomes were identified using univariable and multivariable analysis.

Results

A total of 405 patients were included in the final analysis. Five-year overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), and locoregional relapse-free survival (LRFS) estimates were 47.7% (95% confidence interval [CI] 42.0–53.2%), 68.7% (95% CI 63.7–73.7%), 42.1% (95% CI 36.7–47.4%), and 44.3% (95% CI 38.8–49.7%), respectively. In a multivariable model, increasing clinical tumor stage of the residual/recurrent/second primary tumor, increasing number of metastatic cervical lymph nodes retrieved during neck dissection, hypopharyngeal and supraglottic tumor location, positive section margin status and perineural invasion were independent negative prognostic variables for OS, DSS, DFS, and LRFS. The type of second tumor was identified as an additional independent prognosticator for DSS, with local recurrences and second primary tumors having a better prognosis than residual tumor.

Conclusions and Relevance

Favorable oncologic outcomes are reported after STL. Increasing clinical tumor stage, increasing number of metastatic cervical lymph nodes, hypopharyngeal and supraglottic tumor location, positive section margins, and perineural invasion are identified as independent negative prognosticators for all oncologic outcome measures.

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Funding

Statistical analysis was funded through the Vandeputte Walter Hoofd-Halskanker fund of the KU Leuven.

Author information

Author notes

  1. Jeroen Meulemans and Jens Debacker contributed equally to this manuscript and are to be considered as co-first authors.

Authors and Affiliations

  1. Otorhinolaryngology-Head and Neck Surgery, University Hospital Leuven, Herestraat 49, 3000, Louvain, Belgium

    Jeroen Meulemans MD, Hannelore Demarsin MD, Tillo Mennes MD, Pierre Delaere MD, PhD & Vincent Vander Poorten MD, PhD, MSc

  2. Department of Oncology, Section Head and Neck Oncology, KU Leuven, Louvain, Belgium

    Jeroen Meulemans MD & Vincent Vander Poorten MD, PhD, MSc

  3. Department of Head and Skin, Ghent University, Ghent, Belgium

    Jens Debacker MD & Wouter Huvenne MD, PhD

  4. Otorhinolaryngology-Head and Neck Surgery, AZ Sint-Lucas, Ghent, Belgium

    Christophe Vanclooster MD & Peter Neyt MD

  5. Otorhinolaryngology-Head and Neck Surgery, AZ Sint-Jan, Brugge, Belgium

    Tillo Mennes MD & Tom Vauterin MD

  6. Head and Neck Surgery, Ghent University Hospital, Ghent, Belgium

    Wouter Huvenne MD, PhD

  7. Interuniversity Institute for Biostatistics and Statistical Bioinformatics, Louvain, Belgium

    Annouschka Laenen MSc

Authors
  1. Jeroen Meulemans MD
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  2. Jens Debacker MD
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  3. Hannelore Demarsin MD
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  4. Christophe Vanclooster MD
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  5. Peter Neyt MD
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  6. Tillo Mennes MD
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  7. Tom Vauterin MD
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  8. Wouter Huvenne MD, PhD
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  9. Annouschka Laenen MSc
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  10. Pierre Delaere MD, PhD
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  11. Vincent Vander Poorten MD, PhD, MSc
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Corresponding author

Correspondence to Vincent Vander Poorten MD, PhD, MSc.

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Disclosures

Jeroen Meulemans, Jens Debacker, Hannelore Demarsin, Christophe Vanclooster, Peter Neyt, Tillo Mennes, Tom Vauterin, Wouter Huvenne, Annouschka Laenen, Pierre Delaere, and Vincent Vander Poorten declare they have no financial interests in relation to the content of this article.

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Meulemans, J., Debacker, J., Demarsin, H. et al. Oncologic Outcomes After Salvage Laryngectomy for Squamous Cell Carcinoma of the Larynx and Hypopharynx: A Multicenter Retrospective Cohort Study. Ann Surg Oncol 28, 1751–1761 (2021). https://doi.org/10.1245/s10434-020-09017-0

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  • DOI: https://doi.org/10.1245/s10434-020-09017-0

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