European Archives of Oto-Rhino-Laryngology

, Volume 256, Issue 2, pp 78–82

The impact of preoperative tracheotomy on T3 transglottic carcinomas of the larynx

  • J. F. Carrillo
  • M. Frías-Mendívil
  • C. Lopez-Graniel
  • A. I. Beitia
  • F. J. Ochoa-Carrillo
Laryngology

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.

Key words Transglottic carcinoma of the larynx Laryngectomy Preoperative tracheotomy 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • J. F. Carrillo
    • 1
  • M. Frías-Mendívil
    • 1
  • C. Lopez-Graniel
    • 1
  • A. I. Beitia
    • 1
  • F. J. Ochoa-Carrillo
    • 1
  1. 1.Division of Surgery, Instituto Nacional de Cancerologia, Av. San Fernando No. 22, Tlalpan 14000, Mexico City, MexicoMX
  2. 2.Selva 45 Apt. 401, Omega Building, Col. Insurgentes Cuicuilco 04530, Mexico City, MexicoMX

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