Gallegos-Hernández JF, Minauro-Muñoz G, Arias-Ceballos H, Hernández-San JM, Flores-Díaz R, Reséndiz-Colosia J

Language: Spanish
References: 12
Page: 213-217
PDF size: 52.40 Kb.

ABSTRACT

Background: We undertook this study to evaluate the results obtained with conservation therapy of the larynx in patients with epidermoid carcinoma of the larynx-pharynx.
Methods: Patients with stages I and II epidermoid cancer of the larynx and pharynx were included. All were evaluated endoscopically, functionally, and with cervical tomography. Results of the procedures were evaluated on the basis of oncological control and laryngeal function (voice, deglutition and ventilation).
Results: There were 41 male patients with a median age of 55 years. In 32 patients, surgery was the initial treatment and in nine patients as rescue after radiotherapy. In 58.5% the location was glottic, in 22% supraglottic, in 12% glotto-supraglottic and in 7% vallecular and hypopharynx. Subtotal laryngectomy was performed with cricohyoidepiglottopexy in 18 patients, frontolateral in 11, supraglottic in 5, subglosso-epiglottectomy in 3, hemipharynx-laryngectomy in 3, and in one hemiglottectomy. The time of decannulation and removal of nasogastric catheter depended on the type of surgery. One patient (2%) had to be subjected to a rescue laryngectomy due to constant aspiration. This patient demonstrated residual tumor in the sample. Nine patients had some type of complication, the most frequent being wound infection (7.3%). One patient died posoperatively due to sepsis (2.4%), and another patient died due to systemic causes 4 months after the intervention. Median follow-up time is 25 months and no patient has presented tumor recurrence.
Conclusions: Voice conservation surgery is an alternative to mutilation of the larynx in patients with locally advanced neoplasms of the larynx with a high risk of recurrence if treated with radiotherapy.

REFERENCES

1. 1. Lydiatt WM, Lydiatt DD. The larynx: early stage. In: Shah JP, ed. Cancer of the Head and Neck. Hamilton, BC: Decker;2001. pp. 169-184.

2. 2. Carew W. The larynx: advanced stage disease. In: Shah JP, ed. Cancer of the Head and Neck. Hamilton, BC: Decker;2001. pp. 156-168.

3. 3. Thompson LDR, Wenig BM, Hefner DK, et al. Controversies in the management of laryngeal cancer: results of an international survey of patterns of care. Radiother Oncol 1994;31:23-32.

4. 4. Janot F, Julieron M. Chirurgie conervatrice des cancer des vois aérodigestives supériores. Bull Cancer 2002;89:1011-1017.

5. 5. Guerrier Y, Pinel J, Cachin Y, et al. La chirurgie conservatrice dans le traitemnt des cancers du vestibule laryngé et du sinus piriforme. Paris: Libraire Arnete;1972.

6. 6. Cortés-Arroyo H, Rodríguez-Cuevas S, Labastida AS. Quality control in planning and technique of radiotherapy with cobalt-60 for T1 glottic cancer increases local control and organ preservation. Am J Surg 1997;174:477-478.

7. 7. Rodríguez-Cuevas S, Labastida S, González D, Briseño N, Cortés H. Partial laryngectomy as salvage surgery for radiation failures in T1-T2 laryngeal cancer. Head Neck 1998;20:630-633.

8. 8. Pinel J, Cachin Y, Laccourreye H, et al. Cancer du larynx. Indication thérapeutiques, resultats. Paris: Libraire Arnette;1980.

9. 9. Piquet JJ. Laryngectomies partielles, subtotales et totales. Paris: Encyclopédie Médico-chirurgicale;1993. pp. 1-13.

10. 10. Farrag TY, Koch WM, Cummings CW, et al. Supracricoid laryngectomy outcomes: The Johns Hopkins experience. Laryngoscope 2007;117:129-132.

11. 11. León X, López M, García J, et al. Supracricoid laryngectomy as salvage surgery after failure of radiation therapy. Eur Arch Otorhinolaryngol 2007;13:809-814.

12. 12. Luna-Ortiz K, Núñez-Valencia ER, Tamez-Velarde M, Granados-García M. Quality of life and functional evaluation after supracricoid partial laryngectomy with cricohyoidoepiglottopexy in Mexican patients. J Laryngol Otol 2004;118:284-288.