The results of salvage surgery combined with reirradiation in nodal recurrence of larynx cancer

Abstract

The recurrence in the regional lymph nodes of patients after total laryngectomy and postoperative radiotherapy is a still serious therapeutic problem. The conditions that are altered following the combined primary treatment make it difficult to achieve satisfactory results of the second surgical treatment.The aim of our study was to evaluate the outcome of a salvage operation (lymphadenectomy) and reirradiation in 50 patients with recurrence in regional lymph nodes (rN). Beetwen 1991 and 1996, 650 patients with larynx carcinoma were treated in our institiutions. All patients during the primary irradiation received a total dose of about 60 Gy. In the case of regional recurrence (rN) patients had selective lymphadenectomy and reirradiation (total dose 40 Gy) when capsulae were found to be infiltrated. The survival rates were for 1, 2 and 3 years : 34 (68%), 22 (44%), only 9 (18%) respectivly. This strategy of a second combined treatment had a good tolerance level, without any unacceptable side effects (complications).