Korean J Otolaryngol-Head Neck Surg.  1997 Nov;40(11):1571-1577.

Cancer Invasion to Laryngeal Cartilage after Radiation Therapy in Salvaged Laryngectomy Specimens

• Chon KM
• Wang SG
• Goh EK
• Roh HJ
• Kim SG
• Shim WY
• Suh KS

Abstract

BACKGROUND: Many head and neck surgeons preferred the radiotherapy as a first choice in treating early laryngeal carcinoma(T1, T2) to surgical operation because of the relatively high curability(80-90%), organ preservation and better quality of life. If radiotherapy failed, some surgeons perform total laryngectomy as salvage operation, but others prefer to perform partial laryngectomy, which is increasing in tendency.
OBJECTIVE
To investigate the pattern of cancer invasion to the laryngeal cartilages using salvage laryngectomized cancer specimens which had recurred after radiotherapy. MATERIALS & METHOD: Preoperative computerized tomograpy images were retrospectively compared to postoperative salvage laryngectomized cancer specimens which had recurred after radiotherapy 13 cases from March, 1985 to February, 1994.
RESULTS
1) In laryngeal cacer recurred after radiotherapy, incidence of cartilage invasion was not in early supragolttic cancer. but all in advanced supraglottic cancer, and 3cases of 5 cases(60.0%) in early glottic cancer, 4cases of 5 cases(80.0%) in advanced glottic cancer. 2) The order of laryngeal cartilage invasion was the first thyroid cartilage(61.5%), the second arytenoid cartilage(30.7%), and the third cricoid cartilage(23.1%). 3) The diagnostic accuracy of preoperative CT scan for laryngeal cartilage invasion was 66.7% in thyroid cartilage, 55.6% in arytenoid cartilage, 55.6% in cricoid cartilage, and 100% in epiglottis.
CONCLUSION
Selection of partial laryngectomy as salvage operation should be considered carefully.

Keyword

Salvage laryngectomy; Laryngeal cartilage invasion; Whole organ section

MeSH Terms

Arytenoid Cartilage
Cartilage
Cricoid Cartilage
Epiglottis
Head
Incidence
Laryngeal Cartilages*
Laryngectomy*
Neck
Organ Preservation
Quality of Life
Radiotherapy
Retrospective Studies
Thyroid Cartilage
Thyroid Gland
Tomography, X-Ray Computed