CHICAGO, ILLINOIS

Surgery or radiotherapy results in cure rates greater than 80% for early-stage supraglottic laryngeal tumors. In this paper, we evaluate the feasibility of supraglottic laryngectomy in place of total laryngectomy for irradiation failures. We performed a retrospective review of 478 patients with an original diagnosis of supraglottic laryngeal cancer. Seventy-seven (16.1%) were treated with radiotherapy for cure. Of the 77 patients treated by irradiation alone, 21(27.3%) failed either at the primary site or in the neck. Among those who failed radiotherapy, 15 (71.4%) were treated by salvage total laryngectomy with or without neck dissection, while the remaining 6(28.6%) were treated by supraglottic laryngectomy with or without neck dissection. Of these, 4 are alive and free of disease. Meticulous surgical technique is essential in order to successfully perform the surgery. Supraglottic laryngectomy should be considered as an alternative to total laryngectomy as a salvage procedure for irradiation failure of early supraglottic cancers.