Clinical and functional outcomes after total laryngectomy and laryngopharyngectomy: Analysis by tumor subsite, salvage status, and extent of resection.

BACKGROUND

Outcomes following surgical intervention for laryngeal and hypopharyngeal tumors are dependent on several factors. In the present study, we sought to determine whether tumor subsite, salvage status, and extent of resection influenced postoperative outcomes.

METHODS

Retrospective review of 107 patients at a single institution who underwent total laryngectomy or partial/total laryngopharyngectomy.

RESULTS

Hypopharyngeal subsite and total laryngopharyngectomy subgroups had inferior speech and swallow outcomes compared to their respective cohorts (P < .05). Salvage patients had inferior 3-year overall survival (P < .05) and swallow outcomes (P < .001). Previously radiated patients had increased fistula rates (29.9% vs 10%, P = .02), and the use of tissue coverage in salvage total laryngectomy had a protective effect on fistula formation (10% vs 37%, P = .04).

CONCLUSIONS

By stratifying patients across multiple subgroups, we provide a detailed narrative in surgical outcomes that can be incorporated into treatment planning. Further prospective studies are needed to compare surgical outcomes to those of organ preservation therapy.