Conservation surgery for radiation‐failure carcinoma of the glottic larynx

A consecutive series of 28 patients treated by conservation surgery of the larynx for radiation‐failure, recurrent rT₁ and T₂ (postradiotherapy staging) glottic squamous cell carcinoma treated at Memorial Sloan‐Kettering Cancer Center from 1966 to 1983 is reviewed. The majority of patients were men with the age ranging from 46 to 76 years. The disease‐free interval ranged from 0 to 113 months (median, 8.5 months). The stage at presentation was rT₁ in 25 patients and rT₂ in 3 patients. Surgery consisted of cordectomy (7 patients), hemilaryngectomy (18), and extended hemilaryngectomy (3). There was no operative mortality. Local recurrence developed in 8 patients (28.5%), cervical metastasis in 2, and distant metastasis in 1. Only 3 patients were salvaged by further treatment. The rate of local control was influenced by positive surgical margins. Overall, voice preservation was achieved in 75% of patients. The ultimate local control was 82.1% during a follow‐up period that ranged from 1.3 to 16.7 years (median, 6.3 years). The actuarial survival at 5 and 10 years was 73% and 71% following conservation surgery of the larynx.