Factors influencing long-term survival following salvage total laryngectomy after initial radiotherapy or conservative surgery.

Abstract

This retrospective study investigated survival outcomes of salvage total laryngectomy (STL) after initial radiation therapy (RT) or larynx conservation surgery (CS) at an academic center. 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). 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 between 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). 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.