Evolution of the epidemiology and clinical characteristics of larynx and hypopharynx carcinoma in Poland from 1991 to 2001

A retrospective analysis was performed of 12,888 cases of larynx and hypopharynx carcinoma diagnosed in 19 ENT Departments in Poland during an 11-year period from 1991 to 2001. An assessment of basic epidemiological data, including also tumor site and disease stage at the time of diagnosis, was conducted. Epidemiological trends over the 11-year period of the analysis were examined. The average M:F proportion was 8:1, with a significant increase in the number of female patients during the analyzed period. The predominant localization of carcinoma was in the glottis (47.2%), followed by the supraglottis (40.3%) and pyriform sinus (7.8%). A significant increase in pyriform sinus tumors was observed in the analyzed period. Majority of cases (57.4%) presented with local advanced stage (T3 + T4) carcinoma of the larynx and hypopharynx, with the highest rate (81.0%) for the pyriform sinus carcinomas, and with the lowest rate for glottic tumors (41.8%). Regional lymph node metastases were diagnosed in 47.7% of the analyzed cases, with the highest rate (82.2%) in cases of pyriform sinus carcinomas, and the lowest (31.7%) in glottic carcinomas. In the 11-year period, a significant drop in N0 cases and a tendency toward increased rates of N2 and N3 lymph nodes metastases cases of supraglottic carcinoma were observed. Distant metastases at the time of diagnosis were registered in 2.2% of the analyzed cases, with the highest percentage in the posterior pharyngeal wall (7.6%) and pyriform sinus (7.4%) carcinomas.     

Distant metastases from laryngeal and hypopharyngeal cancer.

A retrospective tumor registry analysis of patients with squamous cell carcinoma (SCC) of the larynx and hypopharynx who were treated with curative intent in the Department of Otolaryngology--Head and Neck Surgery at Washington University School of Medicine and Barnes Hospital between January 1971 and December 1991. In 2,550 patients, the mean age, sex and tumor differentiation did not affect the incidence of distant metastases. The overall incidence of distant metastases was 8.5% (217/2,550 patients) with the following distribution: glottis 4.4%, supraglottis 3.6%, subglottis 14%, aryepiglottic fold 16%, pyriform sinus 17% and posterior hypopharynx 17.6%. The overall 5-year disease-specific survival for distant metastases was 6.4%. Distant metastases were related to advanced local disease (T3 + T4), lymph node metastases at presentation (N+), tumor location (hypopharynx) and locoregional tumor recurrence (p < or = 0.028). A meta-analysis of variables which predispose to a higher incidence of distant metastases indicate that tumor location (hypopharynx > larynx), advanced primary disease (T3 + T4), regional disease (N+), locoregional recurrences, and advanced regional metastases (N2 + N3) are statistically significant.     

Delayed regional metastases, distant metastases, and second primary malignancies in squamous cell carcinomas of the larynx and hypopharynx

OBJECTIVE: To determine the impact of delayed regional metastases, distant metastases, and second primary tumors on the therapeutic outcomes in squamous cell carcinomas of the larynx and hypopharynx. STUDY DESIGN: Chart review and statistical analysis. METHODS: A retrospective tumor registry analysis was made of patients with squamous cell carcinomas of the larynx and hypopharynx who were treated with curative intent in the Department of Otolaryngology-Head and Neck Surgery and the Radiation Oncology Center of the Washington University School of Medicine (St. Louis, MO) between January 1971 and December 1991 and developed delayed regional metastases (2 y after treatment), distant metastases, and second primary malignancies. RESULTS: In 2550 patients, the mean age (59.8 y), sex (8.5 male patients and 1 female patient), and tumor differentiation did not affect the incidence of delayed distant, regional, or second primary malignancies. The overall incidence of delayed regional metastases was 12.4% (317/2550 patients); distant metastases, 8.5% (217/2550); and second primary tumors, 8.9% (228/2550), with a 5-year disease-specific survival of 41%, 6.4%, and 35%, respectively. Second primary malignancies were not statistically related to the origin of the primary tumor, tumor staging, or delayed regional and distant metastases (P =.98). Delayed regional metastases and distant metastases were related to advanced primary disease (T4 stage), lymph node metastases (node positive [N+]), tumor location (hypopharynx), and locoregional tumor recurrence (P < or =.028). Advanced regional metastases at initial diagnosis (N2 and N3 disease) increased the incidence of delayed and distant metastases threefold (P =.017). These two metastatic parameters were significantly greater in hypopharyngeal tumors than in laryngeal tumors (P =.037). The incidences of delayed regional metastases by anatomical location of the primary tumor were as follows: glottic, 4.4%; supraglottic, 16%; subglottic, 11.5%; aryepiglottic fold, 21.9%; pyriform sinus, 31.1%; and posterior hypopharyngeal wall, 18.5%. The incidences of distant metastases were as follows: glottic, 4%; supraglottic, 3.7%; subglottic, 14%; aryepiglottic fold, 16%; pyriform fossa, 17.2%; and posterior hypopharyngeal wall, 17.6%. Seventeen hypopharyngeal tumors (2%) presented with M1 disease. Delayed regional metastases to the ipsilateral treated neck had a significantly worse survival prognosis than delayed metastases to the contralateral nontreated neck (P =.001). CONCLUSIONS: Conclusions are as follows: 1) The incidence of second primary tumors is independent from the primary tumor staging and distant and delayed regional metastases. The highest incidence occurred in patient groups with the highest disease-free survival rates (P =.0378). 2) Highest incidence of delayed and distant metastases occurred in hypopharyngeal tumors and was three times greater than in laryngeal cancers (P =.028). 3) Salvage therapeutic rates were poor for delayed metastases to the ipsilateral treated nodes and distant metastases as compared with contralateral neck metastases and second primary tumors (P =.001). 4) Delayed and distant lymph node metastases were significantly higher in advanced primary disease (T4 stage), locoregional recurrences, and regional disease (N2 and N3) (P =.028) in both the larynx and hypopharynx. 5) The higher incidence of delayed and distant metastatic disease was related to more advanced initial tumor presentation in hypopharyngeal cancer as compared with laryngeal cancer (P =.039). 6) Incidence of distant metastases was greatest between 1.5 and 6 years after initial treatment with a mean incidence being less than or equal to 3.2 years.     

Diagnostic problems in a case of the pyriform sinus carcinoma in a man

Despite a use of many diagnostic tools to assess the stage of the carcinoma of hypopharynx and larynx various problems can still arise. A 45 years old man was admitted with an initial diagnosis of carcinoma of the hypopharynx with metastases to neck lymphnodes (Tin situ N1). Computed tomography of the neck revealed pathologic remodeling of the thyroid cartilage. An oncologist decided to commence a chemotherapy. After 4 cycles of chemotherapy a second CT scan revealed a suspected neoplastic infiltration of the cricoid and thyroid cartilages. After that the patients was disqualified from both radio- and chemotherapy. The consulting laryngologist did not find any pathologies in the larynx and hypopharynx. On palpation there were no enlarged neck lymph nodes. The second specimen taken from the right pyriform sinus was a loosen fragment of the epithelium with the Ca male differentiatum G3. The positron emission tomography imaging found a suspected site 11 mm in diameter situated in front of the carotid vessels. The neoplastic infiltration of the larynx was not confirmed. The patient started the radiotherapy. We are of the opinion that in the presented case the erroneous interpretation of the CT scan was a likely consequence of the improper setting of a window of brightness and contrast. Strong artifacts are also observed in 3D imaging. Another cause of the diagnostic problems could stem form an unfinished calcification of the cartilages which produced an image of irregular areas of calcification and rarely diagnosed T in situ in a pyriform sinus.     

The submandibular triangle in squamous cell carcinoma of the larynx and hypopharynx

A 15-year retrospective analysis was carried out at the University of Illinois College of Medicine, Chicago, reviewing the tumor staging and pathology data of 239 patients treated for carcinoma of the larynx and hypopharynx requiring laryngectomy alone, laryngectomy with neck dissection, or laryngopharyngectomy and neck dissection. Surgery was the primary treatment modality in 205 of the 239 cases, with the remaining 34 having surgery to treat radiation therapy failure. Primary tumors were located within the supraglottic region, the glottic region and, less commonly, the pyriform sinus. Ninety-five of the 239 patients either presented with or developed nodal metastases following initial treatment. Of these, only two had tumors within the lymph nodes of the submandibular triangle. This data corroborates impressions that tumors of the larynx and hypopharynx rarely metastasize to the submandibular triangle and that sparing this area during neck dissection for lesions of the larynx would seem justified.     

Distant metastases of epitheliomas of the upper respiratory and digestive tracts

Distant metastases of ENT tumors are rare; when analysing 1.666 patients, we found them in 6.5%. They started especially from tumors of the hypopharynx (19.7%), oral cavity (7.6%), oropharynx (5.6%) and larynx (3.2%). 9 metastases were diagnosed, before therapy started, all the others appeared late, even later than 5 years after therapy in some cases of carcinoma of the larynx. The metastases were situated in the lung (71 cases), the skeleton (45 cases), the pleura (11 cases) and the liver (8 cases), but in rare instances in almost every organon. The main examinations for staging are therefore: the radiograph of the chest, the sonography of the abdomen and the scintigraphy of the skeleton. These examinations may be completed, if necessary, by the CT-scan. A patient with distant metastases never could be healed.     

The risk of contralateral lymphatic metastases for cancers of the larynx and pharynx.

PURPOSE: This study was undertaken to determine the risk of cervical metastases to the contralateral side in patients treated for carcinoma of the larynx and pharynx. PATIENTS AND METHOD: Retrospective evaluation of 846 patients treated between 1962 and 1981 with carcinoma of the supraglottis, transglottis, and pyriform sinus were reviewed. Lesions were classified as either transglottic with fixed vocal cord (TG-F), transglottic with mobile vocal cords (TG-M), central supraglottic (SG-C), marginal supraglottic (SG-M), glossoepiglottic cancers of the suprahyoid epiglottic, vallecula, and tongue base (SG-GE), and cancers of the pyriform sinus (PS). RESULTS: Contralateral lymph node metastases were identified at presentation or later developed in SG-GE 26%, SG-M 14%, PS 13%, SG-C 7%, TG 4%. Contralateral metastases were significantly higher in patients with ipsilateral metastasis. The risk of contralateral metastasis was unrelated to the primary tumor size. CONCLUSIONS: All but 79 patients received variable doses of irradiation to the contralateral neck. Therefore, the risk of metastatic disease is probably higher than reported. Parotid-sparing radiation technique is suggested for centrally located cancers of the supraglottis and transglottis when ipsilateral nodes are not involved because the risk of contralateral neck involvement is sufficiently low that opposite neck irradiation may be safely avoided.     

Hemipharyngectomy and hemilaryngectomy for pyriform sinus cancer: Reconstruction with remaining larynx and hypopharynx and with tracheostomy

When resection of the posterior hypopharyngeal wall is undertaken for treatment of pyriform sinus carcinoma, a very narrow mucosal strip may be left for reconstruction. A surgical technique for carcinoma which has invaded the whole lateral hypopharyngeal wall is described. It consists of resecting half the larynx and half the hypopharynx and reconstructing the food canal using the mucosa of the unaffected half of the larynx and the remnant hypopharynx. A series of 34 patients treated by this technique is presented. No hypopharyngeal stenosis was observed. Local recurrences developed in 9 cases and distant metastases in 6. A specific disease mortality rate of 44% was encountered. At present, 15 patients are disease-free after a median follow-up of 48 months.     

Nodal patterns in carcinoma larynx and hypopharynx

The therapeutic choice for a malignant neoplasm is usually governed by the probability and location of lymph mode metastases. In the present study 47 cases of carcinoma larynx and 44 cases of carcinoma hypopharynx were throughly investigated and reviewed. Among the laryngeal malignancies supra glottic and transglottic tumours were equally frequent (46.8%). Among the hypopharyngeal malignancies, pyriform fossae were most frequently invloved (90.9%). In laryngeal malignancies (51.06%) as well as hypopharangeal malignancies (77.27%) T⁴ tumour were more common. Overall incidence of cervical metastases was (63.83%) in laryngeal carcinoma and (45.45%) in hypopharyngeal carcinoma respectively. In majority of laryngeal carcinoma cervical modes were present at level B followed by level E. In hypopharyngeal malignancies mode B and E were only involved. There was definite correlation between ‘T’ of the primary tumour, and node status but there was no correlation between ‘T’ and node level. The study stresses on the relevance of nodal pattern examination and radiological investigations in all cases of carcinoma larynx and hypopharynx.     

Superficial extending carcinoma of the hypopharynx: Report of 26 cases of an underestimated carcinoma

Advanced ulcerating and infiltrating tumors are commonly found in the hypopharynx, whereas early well-defined lesions are rarely diagnosed. The pathologic reports of 242 uniformly studied surgical specimens after total pharyngolaryngectomy for cancer of the hypo-pharynx were reviewed. The histologic analysis of 26 cancers (10.7%), which were recorded as having an entire or predominant superficial type of spreading, demonstrated that also in the hypopharynx a “superficial extending carcinoma” (SEC) may occur. SEC of hypopharynx was pathologically defined as a poorly or moderately differentiated squamous cell carcinoma, generally located in the pyriform sinus, which spreads superficially. It was limited to the mucosa (2.9%), but more frequently early infiltrated the underlying muscle or gland structures (6.2%), regardless of the presence of lymph node metastases or lymph vessels invasion. Although the concept that SEC of the hypopharynx may be an expression of a generalized disease of the mucosa must be carefully considered in surgical management, it appeared that this carcinoma in its “pure” intramucosal form may be associated with a good prognosis and a long survival.     

Histologic correlation of expression of Ki-67 in squamous cell carcinoma of the glottis according to the degree of cell differentiation

IntroductionSquamous cell carcinoma is the most common neoplasm of the larynx and glottis, and its prognosis depends on the size of the lesion, level of local invasion, cervical lymphatic spread, and presence of distant metastases. Ki-67 (MKI67) is a protein present in the core, whose function is related to cell proliferation.AimTo evaluate the expression of marker Ki-67 in squamous cell carcinoma of the larynx and glottis and its correlation to pathological findings.MethodsExperimental study with immunohistochemistry analysis of Ki-67, calculating the percentage of the cell proliferation index in glottic squamous cell carcinomas.ResultsSixteen cases were analyzed, with six well-differentiated and 10 poorly/moderately differentiated tumors. There was a correlation between cell proliferation index and degree of cell differentiation, with higher proliferation in poorly/moderately differentiated tumors.ConclusionThe cell proliferation index, as measured by Ki-67, may be useful in the characterization of histological degree in glottic squamous cell tumors.     

Sarcomatoid carcinoma of the pyriform sinus with brain and subcutaneous metastases: an unusual metastatic spread pattern

A 63-year-old man presented a polypoid tumor in the laryngeal space involving the right pyriform fossa. The patient underwent a total laryngectomy with bilateral functional neck dissection, and the diagnosis of sarcomatoid carcinoma with malignant fibrous histiocytoma-like stroma was established. The tumor showed an uncommon behavior, with distant metastases to the brain and to the subcutaneous tissue of the abdominal wall. The patient died 1 year after the development of the metastases. Despite its polypoid pattern of growth, sarcomatoid carcinoma of the larynx may behave very aggressively. It is important for clinicians to be aware of the possibility of distant subcutaneous and brain metastases in sarcomatoid tumors of the laryngeal space. If such metastases develop, the prognosis is ominous, with an average life expectancy of 3 months. Received: 3 March 2000 / Accepted: 6 April 2000     

Epidemiologia raka krtani i gardła dolnego w latach 1988–2012 w materiale Kliniki Otolaryngologii Uniwersytetu Medycznego w Białymstoku

Malignant tumour is the second cause of death in Poland, behind cardiovascular disease. 26% of men and 23% of women die of it. Head and neck tumours are the fifth most frequent group of malignant tumours. These are mostly squamous cell carcinomas. The carcinogenic factors of tobacco smoke play an indisputable role in the pathogenesis of these tumours.Aim of workAnalysis comprising: number of patients, sex and age, site and stage of the primary tumour (T), clinical assessment of neck lymph nodes (N). The results underwent statistical analysis.Materials and methodsThe study involved 1313 patients who underwent surgery in the period 1988–2012 in the Otolaryngology Clinic in Bialystok (1199 men and 114 women, aged 32–86 years).ResultsIn the study group the proportion of men was 91.3% and women 8.7%. Histopathological verification confirmed squamous cell carcinomas in 99%. The primary tumour was most often located in the supraglottic area of the larynx (48.0%) and its clinical stage was T3 (33.5%). T1 tumours were statistically significantly more frequently found in the glottis and T4 tumours – in the hypopharynx and in the transglottic area. Swollen lymph nodes in the neck were found in 52.4% of the patients, most often N2 (37.4%). The highest percentage of patients with lymph node reaction was found in the youngest group (76.6%) and the lowest – in the eldest group (30.0%). Swollen lymph nodes were statistically relevantly more frequent in patients with supraglottic or hypopharynx tumour.     

Collision tumor of a hypopharyngeal adenoidcystic carcinoma and a laryngeal squamous cell carcinoma

INTRODUCTION: Malignancies in head and neck cancer are mainly squamous cell carcinomas. Adenoid cystic carcinomas are rare lesions of this site. Laryngeal adenoid cystic carcinoma is estimated to occur in 0.1 - 0.7 % of all laryngeal carcinomas. Adenoid cystic carcinomas are rarely located in the hypopharynx. To our knowledge there is no case report of adenoid cystic carcinoma of the hypopharynx as part of a collision tumor of the larynx. CASE REPORT: A 47-year-old male patient was diagnosed with an adenoid cystic carcinoma of the hypopharynx and a squamous cell carcinoma of the larynx. Because of local extension of both tumors laryngectomy and partial pharyngotomy with bilateral neck dissection was performed followed by radiation therapy. Clinical aspects as well as histomorphological and immunohistochemical criteria of both tumor entities are discussed. DISCUSSION AND CONCLUSIONS: Immunohistochemical characteristics showed two different carcinoma entities in the larynx and hypopharynx. Only by complete histological investigation of a carcinoma those rare cases of a collision tumor can be detected. Both tumor entities need to be considered for therapy strategy and oncological follow-up planning.     

Occult metastases from T1–T2 supraglottic carcinoma: role of primary tumor localization

The present study was undertaken to evaluate the role of localization on the rate of occult metastasis in early stage supraglottic laryngeal carcinoma. We selected carefully 32 T1–2 clinically N0 patients without epilarynx involvement and 39 T1–2 clinically N0 patients with epilarynx involvement from among patients with supraglottic laryngeal carcinoma. All patients underwent simultaneous unilateral or bilateral neck dissection with laryngeal surgery. The rate of the occult metastases was 3.1% in patients without epilarynx involvement, whereas it was 20.5% in patients with epilarynx involvement. Within the supraglottic larynx, two subregions can be distinguished: the epilarynx and the lower supraglottis. Our results suggest the possibility of omitting elective neck treatment in T1–2N0 supraglottic laryngeal carcinoma without epilarynx involvement. Observation under strict follow-up may be an option to routine neck treatment in T1–2N0 supraglottic laryngeal carcinoma without epilarynx involvement.     

喉及下咽鳞癌颈淋巴结隐匿性转移灶的研究

目的 :进一步探讨喉及下咽鳞癌颈淋巴结转移规律 ,为喉及下咽鳞癌颈淋巴结清扫术提供理论依据。方法 :收集 1997年 5月～ 1999年 7月 4 0例临床颈淋巴结阴性 ( c N0 )的喉及下咽鳞癌患者改良根治性颈清扫术所得标本 ,且术前未经任何治疗者为研究病例。对颈清扫淋巴结 (共 2 2 19枚 )进行常规 HE及免疫组化法检查。全部病例随访 1年以上。结果 :喉及下咽鳞癌出现颈淋巴结转移 14例 ( 3 5 % ) ,共 3 1枚 ( 1.4 % )淋巴结 ,其中声门上癌 6例 ( 6/2 0 ) ,跨声门癌 1例 ( 1/1) ,下咽癌 7例 ( 7/10 )。 9例声门癌无颈淋巴结转移。颈淋巴结转移均位于颈 、 区。结论 :喉及下咽鳞癌颈淋巴结转移多发生于患侧颈 、 区 (局限于声门区喉癌除外 )。对于 T2 ～ T4 声门上癌、跨声门癌及下咽癌的 c N0 患者 ,根据其可能发生颈淋巴结隐匿性转移的高危险性 ,建议行患侧或双侧颈 及 区淋巴结清扫术。     

The impact of paratracheal lymph node metastasis in squamous cell carcinoma of the hypopharynx

The aim of this study was to analyze the prevalence and prognostic importance of paratracheal lymph nodes in squamous cell carcinoma of the hypopharynx. A retrospective review of 64 previously untreated patients with squamous cell carcinoma (SCC) of the hypopharynx that underwent surgery was performed. Ipsilateral paratracheal lymph node metastases occurred in 22% (14 out of 64) and the mean number of paratracheal lymph nodes dissected per side was 2.3 (range 1–6). Contralateral paratracheal lymph node metastases were present in 2% (1 out of 42). Sixty-seven percent with postcricoid SCC and 22% with pyriform sinus SCC developed clinical node-positive ipsilateral paratracheal lymph node metastases, whereas 11% with posterior pharyngeal wall SCC developed paratracheal metastases. There was a significant correlation between paratracheal lymph node metastasis and cervical metastasis (p = 0.005), and the primary tumor site (postcricoid, 57.1%; pyriform sinus, 20.0%; posterior pharyngeal wall, 8.3%) (p = 0.039). Patients with no evidence of paratracheal lymph node metastasis may have a survival benefit (5-year disease-specific survival rate, 60 vs. 29%). However, this result did not reach statistical significance (p = 0.071). The patients with SCC of the postcricoid and/or pyriform sinus were at risk for ipsilateral paratracheal lymph node metastasis; furthermore, patients with paratracheal node metastasis had a high frequency of cervical metastasis and a poorer prognosis. Therefore, routine ipsilateral paratracheal node dissection is recommended during the surgical treatment of patients with SCC of the postcricoid and/or pyriform sinus with clinical node metastases.     

喉黏液表皮样癌诊疗初步探讨

目的探讨喉黏液表皮样癌的临床病理特征及预后,提高对喉黏液表皮样癌的诊治水平。方法对12例原发性喉黏液表皮样癌病理学特点、临床表现、治疗和预后进行回顾性分析。本组病例共12例,占喉恶性肿瘤的0.98%,全部为男性,年龄56～74岁,平均60.2岁。声门上型9例,声门型3例,其中6例有颈淋巴结转移。分别进行了喉部分切除、喉全切除及相应的颈清扫术,全部病例均于术后1个月放疗。结果2例分别于术后2、3年死于局部复发;6例随访3～5年,均无瘤生存;4例失访,按死亡处理。结论喉黏液表皮样癌较为罕见,治疗以手术切除为主,术后辅助放疗。     

Occult node metastases in head and neck squamous carcinoma

Summary The present study examined the Liverpool database in an attempt to determine what proportion of N0 necks for various head and neck primary sites harbored subclinical squamous cell carcinoma and whether empiric treatment of occult disease improved survival over and above a wait-and-watch policy (treatment when metastasis becomes manifest). One hundred seventeen neck dissections were carried out for N0 necks, with 32% of specimens found to contain squamous cell carcinoma. The risk of carcinoma was highest in the hypopharynx, with 50% of specimens associated with a pyriform fossa primary cancer. Twenty-nine percent of neck dissection specimens for oral cavity cancer contained carcinoma and this was commonly associated with lateral border of tongue or anterior floor of mouth carcinomas. Twenty-five percent of specimens when primary tumor was in the oropharynx contained carcinoma and were due to tonsillar carcinoma. Twenty-one percent of laryngeal cancers produced histologically positive nodes and were mostly associated with posterior epiglottic tumors. Two hundred forty-six patients had a pyriform fossa cancer and of these only 37 had N0 disease and surgical treatment. Of these, 23 patients had radical neck dissections, whereas in 14 the necks were not treated. There was no difference in survival between the two groups (₁ ² = 0.787, P = NS). The Liverpool database also contained 1631 previously untreated patients with no clinical evidence of neck node metastases. Of these only 107 had a neck dissection. There was no difference in survival (₁ ² = 2.79, P = NS). When these data were analyzed by multivariate methods (Cox's proportional hazards model) prophylactic neck dissection was found to have no significant effect.Based on a presentation at the International Symposium on the N0 neck: Göttingen, September 1992 Correspondence to A. S. Jones     

Results after supracricoid horizontal partial laryngectomy

Objectives

This study analyzed oncological and functional results of supracricoid horizontal partial laryngectomy.

Methods

A retrospective study was conducted involving 20 patients with squamous cell carcinoma (SCC) of the larynx who underwent SCPL between 1996 and 2005 in Faculty of Medical Sciences of Santa Casa Hospital of Sao Paulo, Brazil. There were 18 male and 2 female patients with ages ranging from 39 to 74 years (median = 58 years), of whom 19 were smokers and 14 alcoholics. The tumors were present in the glottis in 16 cases and supraglottis in 4; 5 were stage I or II and 15 were stage III or IV. We analyzed treatment given when rehabilitation was unsuccessful, oncological results of SCPL, including local and regional recurrences, time to recurrence and treatment given, distal metastases, global survival, survival free of disease, and appearance of second primary tumors. We also calculated the index of functional preservation of the larynx.

Results

Rehabilitation of swallowing capabilities and speech was achieved in 18 patients. Removal of the tracheostomy varied between 1 and 9 months. Rehabilitation was unsuccessful in two patients. Three patients required a total laryngectomy, two for unsuccessful rehabilitation and one for recurrence. The preservation of a functional larynx was 85%, with 10% of patients requiring a total laryngectomy after failed rehabilitation.

Conclusions

Supracricoid horizontal partial laryngectomy is an efficient surgical oncology technique that yields good functional results for the treatment of laryngeal cancer.