Prognostic value of resection margins in supracricoid laryngectomy

Objectives: The objective was to assess the prognostic value of surgical margin involvement in patients treated for squamous cell carcinoma of the larynx. Study Design: Retrospective study. Methods: A review was made of 253 patients treated with supracricoid laryngectomy between 1984 and 2001. A histopathological study on the surgical resection margins was performed in all cases. The incidence of local recurrence was correlated with the histological features of resection margins. Results: Forty patients (15.8%) were identified as having positive margins: 29 had invasive carcinoma and 11 had dysplastic lesions. The remaining 213 patients (84.2%) had negative margins. Subsequent follow-up showed that 19 of 253 patients developed local recurrence and 3 patients developed regional recurrence. Nine of these patients had positive resection margins (six with invasive carcinoma and three with dysplastic lesions), and 10 had negative resection margins. Overall survival at 3 years was significantly higher for patients without recurrence than for patients with local or regional failure (89.9% vs. 45.5% [P < .05]). Conclusion: According to results of the study, patients with positive resection margins developed local recurrence more frequently than those with clear resection margins (P < .05).