Partial laryngectomy to treat early glottic cancer after failure of radiation therapy.

OBJECTIVE To evaluate the role of partial laryngectomy to treat glottic cancer after failure of radiation therapy. DESIGN A 12-year retrospective outcome analysis. SETTING University referral center. PATIENTS A total of 19 patients who underwent partial laryngectomy to treat glottic cancer after failure of radiation therapy. RESULTS The follow-up period in this group ranged from 31 to 144 months. After surgery, a laryngocutaneous fistula was observed in 4 cases, and flap necrosis occurred in 2, but these complications were successfully managed. Maximum phonation time after surgery ranged from 3 to 28 seconds (median phonation time, 10.2 seconds). Of these 19 patients, 3 developed local recurrence. These cases were successfully treated with total laryngectomy. A surgical margin of less than 1 mm was found to be a significant risk factor for local recurrence after partial laryngectomy. CONCLUSIONS These results indicate that partial laryngectomy is a useful option for the treatment of irradiation failure in the treatment of stage I and stage II vocal cord carcinomas. However, careful follow-up is mandatory for patients with a small surgical margin.