Low survival of advanced laryngeal cancers: Time to change the treatment regime?

Background: This study aimed to detect the survival outcome of patients who underwent primary laryngectomy in comparison to the salvage total laryngectomy at our institution. Methodology: A retrospective analysis of patients who underwent laryngectomy in our institution from 2009 to 2016 either as primary surgery or as salvage surgery was done. Results: Fifty-four patients were assessed in the current study. Primary laryngectomy was done in 33 (60.4%) patients and savage laryngectomy in 21 (39.6%) patients. The common complication following laryngectomy was wound infection (68.5%) followed by pharyngocutaneous fistula (29.6%). The five year disease free survival in primary and salvage laryngectomy patients were 46% and 32 % respectively. DFS showed a decreasing trend with increase in T-stage and also node positivity. The overall survival (5 years) was found to be 52% for primary laryngectomy cases and 37% for salvage cases. Conclusion: Salvage laryngectomy was found to have higher incidence of postoperative complications. The overall survival and DFS was found to be lesser for salvage cases than primary laryngectomy. T- and N-stage have an important role in determining survival. The survival of advanced laryngeal cancers is dismal with surgery and radiotherapy.