FACTORS INFLUENCING LONG-TERM SURVIVAL FOLLOWING SALVAGE TOTAL LARYNGECTOMY AFTER INITIAL RADIOTHERAPY OR CONSERVATIVE SURGERY

Abstract: Background. This retrospective study investi-gated survival outcomes of salvage total laryngectomy (STL) after initial radiation therapy (RT) or larynx conservation surgery (CS) at an academic center. Methods. A chart review yielded 64 patients with STL: 53 with RT failures, six with CS failures, and five after RT + CS. Median potential follow-up after STL was 9.4 years (mean, 9.2 years; range, 0.3–17.4 years). Results. Five- and 10-year actuarial overall survival (OS) after STL was 65.2 % and 37.7%, respectively. Mean survival after STL was 7.2 years (median, 6.8 years; range, 0.2– 17.4 years). No significant survival difference was found be-tween the three treatment groups (p =.50). For 21 patients with nodes assessed at STL, 9-year OS was 45.4 % for patients with N0 disease versus 26.7 % for patients with N+ disease (p =.25). Conclusion. These data suggest that STL after radiation failure is associated with equivalent long-term survival as STL after RT + CS or after failure of CS alone. A 2005 Wiley Period