Salvage resection after previous laryngeal surgery: Total laryngectomy with en bloc resection of the overlying cervical skin

Objective: To evaluate the effectiveness of extended total laryngectomy for the treatment of recurrences of laryngeal cancer. Design: We conducted a retrospective clinical study of patients who had undergone extended total laryngectomy and were seen over a 15-year period. The follow-up period ranged from 3 to 15 years. Setting: Academic tertiary referral medical center. Patients: We observed 15 patients who were affected by a recurrence of laryngeal cancer that extended to the overlying soft tissue. All patients were male. The mean age was 61.5 years. Thirteen patients had previously undergone partial laryngeal surgery, and 2 patients had undergone radiation therapy, without success. Intervention: All patients underwent total laryngectomy extending to the soft tissue, including the overlying skin. Results: Five of the 15 patients died of local recurrence, and 1 patient died of massive postoperative hemorrhaging. An actuarial survival rate of 60% was observed at 5 years. Conclusion: Total laryngectomy extending to the soft tissues seems to be an effective procedure for treating local recurrences of laryngeal cancer after partial laryngectomy or failure of radiation therapy.