Survival Outcomes and Prognostic Factors of Open Partial Laryngeal Surgery: A Thirty Years' Experience

Ann Otol Rhinol Laryngol. 2020 Jul;129(7):669-676. doi: 10.1177/0003489420905616. Epub 2020 Feb 6.

Abstract

Background: Open partial laryngeal surgery (OPLS) represents a wide array of procedures that can be fitted to treat different types of laryngeal cancer (LC). We would like to present our 30-years' institutional experience, to analyze survival outcomes and to critically discuss prognostic factors.

Methods: We reviewed all cases of OPLS performed at our Institution from 1982 to 2016 for LC. Survival analysis by Kaplan-Meier estimate was performed and prognostic variables by multivariate analysis were identified.

Results: Mean follow-up time was 68.3 months, 30-day mortality 0.2%, subsequent functional total laryngectomy (TL) was 1.01%. Over 80% of cases were stage I to II. We had 25 local, 62 regional and eight distant recurrences. Local control was 94.9%, overall survival (OS) was 83.4% and disease-specific survival (DSS) was 87.7%. The two major risk factors significantly associated with the risk of death were cT and cN stage. CONCLUSIONS: We have confirmed that OPLS represents an oncologically sound option in the treatment of LC despite the emergence of non-surgical strategies and new transoral mininvasive techniques. Our results highlight that accurate staging, correct selection of the patient and a strong surgical expertise are of paramount importance in this type of surgery.

Keywords: head and neck cancer; laryngeal cancer; laryngectomy; laryngology; survival.

MeSH terms

  • Adult
  • Aged
  • Bone Neoplasms / secondary
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / methods*
  • Logistic Models
  • Lung Neoplasms / secondary
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neck Dissection
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Staging
  • Otorhinolaryngologic Surgical Procedures / methods
  • Prognosis
  • Risk Factors
  • Salvage Therapy
  • Survival Rate
  • Young Adult