Oncologic effectiveness of open partial vertical laryngectomy in the treatment of early glottic cancer

Abstract

Introduction . In the last decades, a discernable trend towards more frequent use of endoscopic laser surgery in operative treatment of cancer of the middle part of the larynx is observed. Smaller operative trauma, absence of tracheostomy, short hospitalization time, and better functional outcomes without compromising oncological outcomes are significant reasons for transition to endoscopic methods. However, local recurrence involving anterior commissure develops in every 4th patient. This can explain attempts to return to analysis of possibilities of a surgical alternative – open laryngectomies. Aim . To retrospectively analyze the oncologic effectiveness of open partial vertical laryngectomy in the treatment of early glottic cancer. Materials and methods . Results of treatment of 66 patients aged between 39 and 72 years (mean age 61.4 ± 8.7 years) with cT1–2N0m0 glottic cancer were analyzed. 33 patients had T1 tumors and 33 – T2. Anterior commissure was involved in 14 cases. Surgery was the only mode of treatment in 92.4 % of cases. Oncologic effectiveness was assessed with the following parameters: the rate of local, regional recurrence and kaplan–meyer overall survival. Results . mean follow up was 58.64 ± 28.33 months (range 8–120 months). The rate of local recurrence for the whole cohort, T1 and T2 cases was 4.5; 3.0 and 6.1 %. The difference in local recurrence rate between T1 and T2 cases was statistically insignificant. The anterior commissure involvement did not affect negatively the rate of local recurrence. Regional recurrence was detected in 3 (4.5 %) patients. Larynx was preserved in 63 patients (92.4 %). 5 year overall survival was 86.12 %. Conclusion . Open partial vertical laryngectomy is characterized by low rate of local recurrence and acceptable functional results. The method may be the optimal choice of treatment for certain subgroup of patients with more advanced and invasive tumors.