The effect of salvage surgery on overall survival rate in patients with recurrent laryngeal carcinoma who were treated with radiotherapy

The Effect Of Salvage Surgery On Overall Survival Rate In Patients With Recurrent Laryngeal Carcinoma Who Were Treated With Radiotherapy Objective: The aim of this study is to analyze the effect of salvage surgery and other factors on overall survival rate in patients with recurrent laryngeal carcinoma who were treated with curative radiotherapy previously. Material and Method: : In this study we retrospectively analyzed 42 patients who had undergone salvage surgery for recurrent laryngeal carcinoma after curative radiotherapy treatment in Cukurova University Hospital between january 2000 and january 2014. The mean follow up time was 48 months (3-10 years). Patients divided into subgroups according to the localisation of recurrent lesion and the type of surgical procedure.The overall three years and five years survival rate after salvage surgery were defined. The complications and their management that occured after salvage laryngectomy were defined. Results: After recurrence five patients had lesion in one site and 37 patients had transglottic lesion. Eight patients had cordectomy, 24 patients had total laryngectomy,10 patients had total laryngectomy and neck dissection.The overall survival rate was %59.5,three years disease free survival rate was %67.2 and five years disease free survival rate was %57.5. Total recurrence rate was %23.8. Five years survival rate in patients with thyroidectomy versus without thyroidectomy were %50.8 and %30.0 respectively, recurrence rate were %33.3 and %6.6 respectively. Five years survival rate in patients with elective neck dissection and those without were %26.7 and %43.1 respectively, recurrence rate were %30.0 and %28.0 respectively. Regarding overall survival and recurrence rate, we did not notice any statistically significant result. Among 34 patients with total laryngectomy, pharyngocutaneous fistula rate was %64.0. %36.3 of these patients were healed with primary suturing and daily dressing,%54.4 repaired with pectoral muscle flapand %9.0 with radial anterior arm flap. Conclusion: Patients with recurrent laryngeal carcinoma treated with radiotherapy previously and had salvage surgery have high risk of complication in this treatment modality. In our series which include limited number of patients the overall survival and recurrence rate in total laryngectomy and organ conservation surgery found to be similar. Key Words: Radiotherapy, recurrence, salvage laryngectomy, laryngeal carcinoma, conservative surgery.