J.ONG1, J.GAN1, E.FU1, H.LI1, S.C.LEE1, C.J.LIM1, M.Y.LIM1
Tan Tock Seng Hospital1
The management of locally advanced laryngeal SCCs is ever-changing, shifting between laryngectomy and chemoradiotherapy. We are interested in the survival rates, and our patients’ outcomes in speech and swallowing.
We included patients who underwent total laryngectomy or pharyngo-laryngectomy for SCC in TTSH between 2006 and 2020. Data such as demographics, stage, margins, lymphovascular invasion (LVI) or perineural invasion (PNI) were collected. Analysis was done using SPSS v26.0. Stepwise Cox regression analysis was used to explore the prognostic factors for recurrence and death. Statistical significance was denoted as p<0.05.
66 patients were included. The mean follow up duration was 51.2 months. 53 were newly diagnosed, 13 had salvage surgery. 97% were males, 82% Chinese, with a mean age of diagnosis at 64 years. The 5-year overall survival (OS) was 60% and 10-year OS was 50%. Disease-free survival (DFS) was 70% at 5-years and 65% at 10-years. Factors affecting survival were poorly differentiated SCC, extranodal extension, high nodal staging and LVI. 38% of our patients had functional speech, while 85% of our patients retained oral feeding.
Laryngectomy with adjuvant therapy remains an equally successful modality of treatment with good survival rates. The rate of long-term tube feeding was 15%, a favourable outcome that is attributable to standard-of-care surgical and reconstruction techniques. We hope to improve functional speech outcomes by adequate preoperative counselling, postoperative rehabilitation and raising the tracheoesophageal prosthesis uptake rate.