JAMA Otol Logo Orlando 2013 AHNS Meeting Location
American Head & Neck Society
Annual Meeting, April 10-11, 2013
JW Marriott Grande Lakes
Orlando, Florida

During the
Combined Otolaryngology Spring Meeting
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Presentation: S026
Topic: Clinical - Organ Preservation Surgery
Type: Oral Presentation
Date: Thursday, April 11, 2013
Session: 01:15 PM - 02:15 PM Salivary / General
Authors: Steven M Sperry, MD, Christopher H Rassekh, MD, Gregory S Weinstein, MD
Institution(s): University of Pennsylvania

Objective: To review the oncologic outcomes following supracricoid partial laryngectomy in a large U.S.-based cohort treated by a single surgeon
Design: Retrospective case series
Setting: Tertiary-care university hospital
Patients: 83 consecutive patients with primary or recurrent squamous cell carcinoma (SCCA) of the larynx undergoing supracricoid partial laryngectomy (SCPL) from 1997-2010. Three radiation failure patients were converted to total laryngectomy (TL) at the time of surgery due to positive margins, and these cases were not included in the subsequent outcomes analyses.
Main Outcome Measures: 5-year local recurrence free survival and laryngeal preservation, based on the Kaplan-Meier method, stratified by prior radiation treatment
Results: There were 44 primary laryngeal tumors and 39 previously treated with radiation to the larynx; 22% were supraglottic or transglottic tumors. Of primary tumors, there were 18 T2 and 24 T3 tumors. The overall 5-year local control rate for the series was 95%, and for T2 and T3 primary tumors the rate was 100% and 95%, respectively. In patients previously treated with radiation, the 5-year local control was 91%, with a 91% laryngeal preservation rate. Amongst stage III or IV primary laryngeal tumors for which concurrent chemoradiation was a treatment alternative, the 5-year local and locoregional control was 95% and 79% respectively, and the 5-year laryngectomy-free survival was 90%. Ultimate local control was achieved for all patients in the series. Hospital charts were available for 76 patients, which demonstrated a significant complication rate of 21% and no perioperative deaths. The rate of complications in previously radiated patients versus primary tumors was not significantly different. Complications included ruptured pexy (n=2), wound infection/fistula (n=4), aspiration/tracheitis (n=4), chyle leak (n=4), c. difficile colitis (n=2), and alcohol withdrawal (n=1). No total laryngectomies were performed for laryngeal dysfunction.
Conclusions: We report the largest series of laryngeal SCC treated with SCPL in the U.S. This series demonstrates excellent local control for both primary and recurrent laryngeal tumors, with functional larynx preservation. In appropriately staged and selected patients with T2 or T3 primary laryngeal tumors, or laryngeal tumors following prior radiation treatment, SCPL should be considered as a treatment alternative to radiation or total laryngectomy.

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