Salvage surgery for recurrent larynx cancer

Head Neck. 2019 Nov;41(11):3906-3915. doi: 10.1002/hed.25925. Epub 2019 Aug 21.

Abstract

Background: Despite advances in treatment, the recurrence rates for laryngeal cancer range from 16% to 40%.

Methods: Patients with recurrent laryngeal cancer treated at Memorial Sloan Kettering (MSK) from 1999 to 2016 were reviewed. Survival outcomes were analyzed.

Results: Of 241 patients, 88% were male; the median age was 67 years; 71% had primary glottic tumors. At initial treatment, 72% of patients were seen with early stage disease; primary treatment was radiation (68%), chemoradiation (29%), and surgery (3%). The most common salvage surgery was total laryngectomy (74%). Forty-seven percentage were upstaged at salvage surgery. The 2- and 5-year disease-specific survival (DSS) was 74% and 57%, respectively. Patients with cT4 disease treated with nonsurgical primary management had a 0% 5-year DSS. Independent predictors of DSS were tumor location, perineural invasion, margin, and stage.

Conclusions: Salvage surgery results in acceptable oncologic outcomes. Stage, disease site, perineural invasion, and margins are associated with inferior DSS.

Keywords: head and neck neoplasm; larynx cancer; prognosis; salvage laryngectomy; treatment failure.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Disease-Free Survival
  • Female
  • Humans
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / therapy*
  • Laryngectomy*
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy*
  • Neoplasm Staging
  • Retrospective Studies
  • Salvage Therapy*
  • Survival Rate