Salvage vertical partial laryngectomy for radiation failurein early glottic carcinoma.

Background: Partial laryngectomy after failure of radiotherapyfor early glottic cancer is an accepted surgical salvage procedure. However,there have been only a few studies on recurrent disease or long-termsurvival. Methods: Twenty-one patients who were treated with salvage partialvertical laryngectomy (PVL) following failure of primary radiotherapywere prospectively studied. Median follow up was 69 months(range 24-204 months). Patients were seen at two- monthlyintervals for the first 24 months and then 3-4 monthlyfor 5 years after their partial surgery or until death. Results: Local control was 71.4% (15/21).Among the six patients who recurred within the larynx, two patientsdeveloped a second primary; one on the ipsilateral false cord at24 months and the other on the contra-lateral vocal cordat 10 years. The no evidence of disease rate followingsalvage PVL was 95%, 85% and 73% at 12,24 and 36 months, respectively, with a mean disease freeinterval of 34.9 months (range 7-120). Survivalwas 90%, 85% and 80% at 12, 24 and 36 months,respectively, with a median survival of 152 months forthe group. Three patients died of their disease and four from othercauses. Four local recurrences occurred within 32 months.Two developed neck metastases and died of their disease. Four patientswere treated successfully with completion laryngectomy. Only oneof these died, but this was due to a second primary squamous cellcarcinoma in the lung. Three of the four patients with local recurrenceshad an extended procedure. Conclusion: Partial vertical laryngectomy is an excellent alternativeto total laryngectomy for salvage following failure of ­radiation.Although local recurrence occurred more frequently in those patientshaving an extended partial procedure, this was not statisticallydifferent. [ABSTRACT FROM AUTHOR]