Diagnosis and treatment of recurrent laryngeal cancer following initial nonsurgical therapy

Ivan Marcelo Gonçalves Agra, Alfio Ferlito, Robert P. Takes, Carl E. Silver, Kerry D. Olsen, Sandro J. Stoeckli, Primož Strojan, Juan P. Rodrigo, João Gonãalves Filho, Eric M. Genden, Missak Haigentz, Avi Khafif, Randal S. Weber, Peter Zbären, Carlos Suárez, Dana M. Hartl, Alessandra Rinaldo, Kwang Hyun Kim, Luiz P. Kowalski

Research output: Contribution to journalReview article

37 Scopus citations

Abstract

Surgery is the preferred modality for curative treatment of recurrent laryngeal cancer after failure of nonsurgical treatments. Patients with initial early-stage cancer experiencing recurrence following radiotherapy often have more advanced-stage tumors by the time the recurrence is recognized. About one third of such recurrent cancers are suitable for conservation surgery. Endoscopic resection with the CO 2 laser or open partial laryngectomy (partial vertical, supracricoid, or supraglottic laryngectomies) have been used. The outcomes of conservation surgery appear better than those after total laryngectomy, because of selection bias. Transoral laser surgery is currently used more frequently than open partial laryngectomy for treatment of early-stage recurrence, with outcomes equivalent to open surgery but with less associated morbidity. Laser surgery has also been employed for selective cases of advanced recurrent disease, but patient selection and expertise are required for application of this modality to rT3 tumors. In general, conservation laryngeal surgery is a safe and effective treatment for localized recurrences after radiotherapy for early-stage glottic cancer. Recurrent advanced-stage cancers should generally be treated by total laryngectomy.

Original languageEnglish (US)
Pages (from-to)727-735
Number of pages9
JournalHead and Neck
Volume34
Issue number5
DOIs
StatePublished - May 1 2012

Keywords

  • conservation laryngeal surgery
  • larynx
  • radiation failure
  • recurrence
  • salvage surgery
  • squamous cell carcinoma

ASJC Scopus subject areas

  • Otorhinolaryngology

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  • Cite this

    Agra, I. M. G., Ferlito, A., Takes, R. P., Silver, C. E., Olsen, K. D., Stoeckli, S. J., Strojan, P., Rodrigo, J. P., Gonãalves Filho, J., Genden, E. M., Haigentz, M., Khafif, A., Weber, R. S., Zbären, P., Suárez, C., Hartl, D. M., Rinaldo, A., Kim, K. H., & Kowalski, L. P. (2012). Diagnosis and treatment of recurrent laryngeal cancer following initial nonsurgical therapy. Head and Neck, 34(5), 727-735. https://doi.org/10.1002/hed.21739