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Original Investigation |

Supracricoid Partial Laryngectomy for Primary and Recurrent Laryngeal Cancer

Steven M. Sperry, MD1; Christopher H. Rassekh, MD1; Ollivier Laccourreye, MD2; Gregory S. Weinstein, MD1
[+] Author Affiliations
1Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia
2Université Paris Descartes Sorbonne Paris Cité Service ORL et Chirurgie Cervico-faciale, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France
JAMA Otolaryngol Head Neck Surg. 2013;139(11):1226-1235. doi:10.1001/jamaoto.2013.4990.
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Importance  Supracricoid partial laryngectomy (SCPL) is an essential technique in the armamentarium of modern laryngeal organ preservation surgery.

Objective, Design, Setting  Retrospective case series to review the oncologic outcomes following SCPL in a large US-based cohort treated by a single surgeon in a tertiary-care university hospital.

Participants  A total of 96 consecutive patients with primary or recurrent squamous cell carcinoma of the larynx undergoing SCPL from 1992 to 2010.

Interventions  Supracricoid partial laryngectomy surgery.

Main Outcomes and Measures  Five-year local control and laryngeal preservation, using the Kaplan-Meier method.

Results  There were 54 primary laryngeal carcinomas and 42 previously treated with radiation to the larynx; 23% were supraglottic or transglottic tumors (n = 22). The overall 5-year local control rate for the series was 94%. For T2 and T3 primary tumors, the 5-year local control was 100% and 96%, respectively. In patients previously treated with radiation, the 5-year local control was 89%, with an 89% laryngeal preservation rate. Among stage III or IV primary laryngeal tumors for which concurrent chemoradiation was a treatment alternative, the 5-year local and locoregional control was 96% and 83%, respectively, and the 5-year larynx preservation was 91%. Ultimate local control was achieved for all patients in the series. A significant postoperative complication occurred in 19% (n = 18) and 1 anesthesia-related perioperative death occurred. No total laryngectomies were performed for laryngeal dysfunction.

Conclusions and Relevance  This series demonstrates excellent local control for both primary and recurrent laryngeal cancers, with functional larynx preservation. In appropriately staged and selected patients with T2 or T3 primary laryngeal cancer or laryngeal cancer following prior radiation treatment, SCPL should be considered as a treatment alternative to non-surgical treatment or total laryngectomy.

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