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ORIGINAL ARTICLE
Year : 2014  |  Volume : 30  |  Issue : 4  |  Page : 332-336

Impact of preoperatative tracheostomy on tracheostome recurrence and overall survival in patients undergoing laryngectomy


Department of Otorhinolaryngology, Ain Shams University, Cairo, Egypt

Correspondence Address:
Tarek A Hamdy
6M, square 1224, Elnoor street, Sheraton Heliopolis, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1012-5574.144966

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Background The development of tracheostomerecurrence after total laryngectomy is a complication with a dismal prognosis .The average survival rate of tracheostome recurrence (TR) is 7.5%, ranging from 1.7% to 40%The TR consists of diffuse infiltration of tumor into the soft tissues of the neck and mediastinum; hence the control of this disease is difficult. Objective To analyze the impact of preoperative tracheostomy ontracheostome recurrence (TR), regional recurrence (RR), and overall survival (OS) in patients undergoing primary laryngectomy. Material and methods Thirty three consecutive patients, who underwent primary total laryngectomy for locally advancedlaryngeal squamous cell carcinoma, were enrolled in this study. Patients whounderwent primary chemo-radiotherapy, partial laryngectomyor those treated palliatively wereexcluded from the study.Patient factors analyzed included age,gender, primarytumor site, TNM classification, type of procedure, thyroid gland management, extent of neck dissection and preoperative tracheostomy (POT). The timeinterval between tracheostomy and definitive surgery was calculated. Results A total of 33 patients underwent total laryngectomy(TL) for squamous cell carcinoma of the larynx.Thirty patients (90.9%) were males, while 3 (9.1%) patients were females. Their mean age was 57.7 (±11.6) years, 26 (78.8%) of them were smokers, their follow up mean time was 23 (±6.6) months. Tracheostomy recurrence occurred in 3 (9.1%) patients and regional recurrence in another 3(9.1%) patients. The 2 years survivalfor the whole patients was 84.8% and overall survival was 81.1%. Nineteen patients had POTbetween 10 to 21days (median 15)prior to TL surgery. Fourteen patients had their tracheostomy at the time of surgery .There was no statistical significant difference between both groups as regard overall survival, stomal recurrence and regional recurrence. Conclusion Our results are in keeping with more recent studies, which suggest that POT is notnecessarily related to stomal recurrence or poor oncological outcome.


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