Prediction of pharyngocutaneous fistula and survival after salvage laryngectomy for laryngohypopharyngeal carcinoma.

Abstract

This study examined the risk factors of pharyngocutaneous fistula development and poor survival after salvage laryngectomy. Binary logistic regression analyses were carried out to analyze the relationship between post-salvage fistula development and variables. Univariate and multivariate Cox proportional hazard regression analyses were performed to evaluate prognostic factors associated with disease-free survival (DFS) and overall survival (OS) after salvage laryngectomy. Multivariate analyses showed that previous radiotherapy and pre-salvage tracheostomy were the independent variables predictive of post-salvage fistula development (all P < .05). The 5-year DFS and OS rates were 58.8% and 45.9%, respectively. Multivariate analyses showed that nodal positivity at salvage remained the independent factor predictive of both DFS (hazard ratio [HR] 2.83, P = .002) and OS (HR 2.22, P = .006). Fistula development after salvage laryngectomy might be predicted by a history of radiotherapy or tracheostomy. Post-salvage survival is associated with nodal positivity at salvage. This study examined the risk factors of pharyngocutaneous fistula development and survival in 103 patients who underwent salvage laryngectomy. Previous radiotherapy and tracheostomy were the independent variables predictive of post-salvage fistula development, and nodal positivity at salvage was the independent factor predictive of both disease-free survival and overall survival.