Abstract
The author performed larynx-conserving surgery on a total of 82 patients （59 primary cases and 23 secondary cases） of laryngeal cancer. The disease-specific 5-year survival rate of all 82 patients was 92.6％. The larynx conservation rate was 87.8％ in all 82 cases. In regard to the treatment of early-stage laryngeal cancer （T1, 2）, we suggested that larynx-conserving surgery should be considered as an option for initial treatment because it is not inferior to radiotherapy in terms of clinical outcome and preservation of laryngeal function in daily life. Larynx-conserving surgery as a salvage treatment for recurrence did not present a lower laryngeal preservation rate than for primary cases, and seemed to be an effective method of salvage surgery for recurrent patients.
Larynx-conserving surgery was performed on 16 patients with locally advanced laryngeal cancer （T3, 4）. These cases included 5 cases of paraglottic space （PGS） invasion and 6 cases of thyroid cartilage invasion. Of these 11 cases, 5 cases whose surgical margins were diagnosed as negative on histopathological examination suffered local recurrence. We performed total laryngectomy as a salvage surgery on these 5 cases. Of the 16 cases of locally advanced cancer （T3, 4）, 5 cases （1 case of deep tongue muscle invasion, 3 cases of anterior invasion of the epiglottis, and 1 case of anterior wall invasion of the cricoid cartilage） showed no local recurrence and local control was successfully achieved with surgery alone. Regarding indications, in the case of locally advanced laryngeal cancer involving anterior invasion of the epiglottis, deep tongue muscle invasion, and anterior wall invasion of the cricoid cartilage, larynx-conserving surgery appropriately indicated because the cases were local controlled with surgery alone. However, in the case of recurrence, postoperative radiotherapy should be considered because of the difficulty of preserving the function of the larynx.
