Background: The purpose of this study was to present our evaluation of the clinical and functional outcomes after salvage total laryngectomy (STL).
Methods: We conducted a retrospective review of 218 patients who underwent STL between 1994 and 2014.
Results: Seventy percent of patients originally had T1 or T2, N0 tumors and 73% had definitive external-beam radiotherapy (EBRT) alone. A majority utilized tracheoesophageal prosthesis (77%) and were gastrostomy free (80%) at last follow-up. The 5-year disease control and overall survival (OS) rates were 65% and 57%, respectively. Patients with a disease-free interval after initial treatment <2 years were more likely to develop a recurrence (p = .001) and die of disease (p = .032) after STL. The disease-free interval after EBRT impacted disease control (p < .001), with 5-year disease control of 92% for >5-year disease-free interval and 60% for <2-year disease-free interval.
Conclusion: Most patients remain disease-free after STL, achieve intelligible tracheoesophageal speech, and maintain an oral diet. Delayed recurrence after initial treatment portends better survival and may indicate a distinct biological profile. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1962-E1968, 2016.
Keywords: complications; disease-free interval; fistula; free flap; laryngectomy; radiotherapy; recurrence; salvage; squamous cell carcinoma.
© 2016 Wiley Periodicals, Inc.