Abstract
In our department, total laryngectomy (TL) has been performed in principle for patients with locally advanced laryngeal cancer. Herein, we evaluated the outcomes of patients treated for locally advanced laryngeal cancer. Of the 36 patients included in this study, 30 patients underwent TL and 6 others, including those who refused surgery, received radiotherapy (RT), and 4 of the 6 patients received concomitant chemotherapy. Cervical recurrence occurred in 5 patients in the TL group, and salvage was possible in 1 of these patients. In the RT group, 1 patient developed distant recurrence, and 1 patient had persistent lymph node involvement following RT but refused to undergo surgery and eventually died of the cancer. Two patients treated with RT for T3 tumors achieved recurrence-free survival. The 3-year disease-specific survival rate was 83.0%; by subsite, it was 81.8%, 88.9%, and 75.0% for the glottis, supraglottis, and subglottis, respectively. According to T staging, the 3-year survival rate was 100% for T3 tumors (n = 13) and 73.0% for T4a tumors (n = 23). According to N staging, it was 91.7% for node-negative tumors (n = 24) and 64.2% for node-positive tumors (n = 12). The results of this study showed that the rate of larynx preservation at 3 years was low at 20.5% for T3 tumors and 8.7% for T4a tumors because the majority of the patients had undergone TL, although overall treatment outcomes were good. Larynx-preserving treatment still remains a challenging issue to be addressed.
