[Long term results of partial laryngectomies in patients suffering from laryngeal cancer]. / Wyniki odlegle operacji czesciowych u chorych na raka krtani.

AIM: The aim of the study was to evaluate the results of partial laryngectomies in patients with laryngeal cancer treated in the 2(nd) Clinical Department of Laryngology SUM in Zabrze in the years 1990-2000. MATERIALS AND METHODS: Retrospective clinical material includes 209 patients in whom surgery was a primary treatment method. No distant metastases (M1) or another malignant cancer were found. The group consisted of 20 (10%) women and 189 (90%) men. The mean age was - 51.2 years. The stage of the neoplasm progression was defined as T1 in 91 patients (44%), T2 in 109 patients (52%). In other 9 patients (4%) the progression stage was T3 and T4. Clinical examination in 191 patients (91%) did not show enlarged lymph nodes in the area of head and neck (N0). In the group of remaining 18 patients (9%) the node progression was found to be N1-N3. In all 209 patients the squamous cell carcinoma of various stage of malignancy (G1-G3) was found in preoperative histopathological tests, out of which five cases were of papillary squamous cell carcinoma. The most common operation in the analyzed group was a chordectomy - 83 surgeries (40%), followed by 38 (18%) vertical partial laryngectomies, 28 (13%) horizontal glottis surgeries, 19 (9%) frontal-lateral and frontal-anterior operations, and supracricoid operations with a reconstruction of CHEP and CHP type, a total of 20 operations (9%). Other types of partial operations were performed less commonly. In 79 patients (38%) partial laryngectomy was complemented with a nodal operation, while cervical lymph nodes were not removed in 130 patients (62%). In 19 cases (9%) the metastases of squamous cell carcinoma to regional lymph nodes were confirmed in postoperative material. 82 patients of the study group (39%) underwent radiotherapy. The median of the observation period was 9 years. Local recurrence, nodal recurrence and distant metastasis are rated as treatment failure. Treatment effectiveness was evaluated with relation to local control, overall survival, disease-free survival and cause specific survival. All the aforementioned parameters were analyzed with the method of updated percentages. The level of statistical significance was assumed to be p ≤ 0.05. RESULTS: The updated 5-year and 10-year percentage of overall survivals was respectively 75% and 63%. The updated 5-year and 10-year percentage of cancer specific survivals was 85% and 79%, respectively. The updated 5-year and 10-year percentage of disease-free survivals was 72% and 56%, respectively. The percentage of 5-year and 10 year local controls was 86% and 79%, respectively.