Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T02:28:33.892Z Has data issue: false hasContentIssue false
  • English
  • Français

Significance of pre-epiglottic space invasion in supracricoid partial laryngectomy with cricohyoidopexy

Published online by Cambridge University Press:  21 September 2007

Y Suoglu ,
M Guven ,
E Kiyak  and
M Enoz
Y Suoglu
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Istanbul University, Tokat, Turkey
M Guven*
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
E Kiyak
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Istanbul University, Tokat, Turkey
M Enoz
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Istanbul University, Tokat, Turkey
*
Address for correspondence: Dr Mehmet Guven, Department of Otorhinolaryngology, Medical Faculty, Gaziosmanpasa University, Tokat, Turkey. Fax:  +9 0356213 31 79 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Cancerous involvement of the pre-epiglottic space has been known for many years to be an important prognostic factor. The aim of this study was to investigate the prognostic value of pre-epiglottic space invasion, according to the degree of invasion (i.e. absence, minimal or gross), and to assess the oncological suitability for supracricoid partial laryngectomy in patients with supraglottic laryngeal carcinomas. This study included 52 patients with squamous cell carcinomas of the supraglottic and glotto-supraglottic larynx, treated with supracricoid partial laryngectomy–cricohyoidopexy, between 1992 and 2001. Clinical and histopathological parameters were evaluated. Pre-epiglottic space invasion was seen in 35 patients (67.3 per cent); there was gross invasion in seven patients and minimal invasion in 28. Neoplastic invasion of the anterior commissure was seen in 18 patients (34.6 per cent) and thyroid cartilage involvement in eight (15.4 per cent). Neoplastic spread through the extralaryngeal tissues was not seen in any patient. The five-year overall survival was 71.5 per cent for patients with gross pre-epiglottic space invasion, 82.2 per cent for those with minimal pre-epiglottic space invasion, and 76.4 per cent for those without pre-epiglottic space invasion. It was observed that gross or minimal pre-epiglottic space invasion did not have a statistically significant effect on survival. Univariate analysis showed that nodal positivity was associated with a poor prognosis. None of the other parameters analysed showed a statistically significant relationship with survival. Four (7.6 per cent) patients had local laryngeal recurrence. Distant metastasis and a second primary tumour were detected in three (5.8 per cent) and four (7.6 per cent) patients, respectively. The five-year overall survival and cause-specific survival were 78.8 and 82 per cent, respectively. Supracricoid partial laryngectomy with cricohyoidopexy can safely be performed in supraglottic and glotto-supraglottic carcinomas with minimal or gross invasion of the pre-epiglottic space which have no extralaryngeal spread. Nodal status is an important predictor affecting survival.

Keywords

Larynx NeoplasmsPartial LaryngectomyEpiglottisPrognosisTumour Metastasis
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 6 , June 2008 , pp. 623 - 627
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 De Santo, LW. Early supraglottic cancer. Ann Otol Rhinol Laryngol 1990;99:593–7CrossRefGoogle ScholarPubMed
2 Dursun, G, Keser, R, Aktürk, T, Akiner, MN, Demireller, A, Sak, SD. The significance of pre-epiglottic space invasion in supraglottic laryngeal carcinomas. Eur Arch Otorhinolaryngol 1997;254(suppl 1):110–12CrossRefGoogle ScholarPubMed
3 Zeitels, SM, Vaughan, CW. Preepiglottic space invasion in “early” epiglottic cancer. Ann Otol Rhinol Laryngol 1991;100:789–92CrossRefGoogle ScholarPubMed
4 Majer, H, Rieder, W. Cricohyoidopexy: a laryngectomy technique in which the airway is permanently protected [in French]. Ann Otolaryngol Chir Cervicofac 1959;76:677–83Google Scholar
5 Labayle, J, Bismuth, R. Total laryngectomy with reconstitution [in French]. Ann Otolaryngol Chir Cervicofac 1971;88:219–28Google ScholarPubMed
6 Laccourreye, O, Brasnu, D, Merite-Drancy, A, Brasnu, D, Chabardes, E, Cauchois, R et al. Cricohyoidopexy in selected infrahyoid epiglottic carcinomas presenting with pathological preepiglottic space invasion. Arch Otolaryngol Head Neck Surg 1993;119:881–6CrossRefGoogle Scholar
7 Bron, L, Brossard, E, Monnier, P, Pasche, P. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy and cricohyoidopexy for glottica and supraglottic carcinomas. Laryngoscope 2000;110:627–34CrossRefGoogle Scholar
8 Targa, L, Grandi, E, Chiarello, G, Farina, A, Carinci, F, Merlo, R et al. Prognostic evaluation in supracricoid partial laryngectomy with cricohyoidopexy. Eur Arch Otorhinolaryngol 2005;262:465–9CrossRefGoogle ScholarPubMed
9 Chevalier, D, Piquet, JJ. Subtotal laryngectomy with cricohyoidopexy for supraglottic carcinoma: review of 61 cases. Am J Surg 1994;168:472–3CrossRefGoogle ScholarPubMed
10 Robbins, KT, Michaels, L. A study of whole organ cancerous larynges to determine resectability by conservation surgery. Head Neck 1984;7:2–7CrossRefGoogle ScholarPubMed
11 Kirchner, JA, Carter, D. Intralaryngeal barriers to the spread of cancer. Acta Otolaryngol (Stockh) 1987;103:503–13Google Scholar
12 De Vincentis, M, Minni, A, Gallo, A. Supracricoid laryngectomy with cricohyoidopexy (CHP) in the treatment of laryngeal cancer: a functional and oncological experience. Laryngoscope 1996;106:1108–14CrossRefGoogle Scholar
13 Schwaab, G, Kolb, F, Julieron, M, Janot, F, Le Rinant, AM, Mamelle, G et al. Subtotal laryngectomy with cricohyoidopexy as first treatment procedure for supraglottic carcinoma: Institut Gustave-Roussy experience (146 cases, 1974–1997). Eur Arch Otorhinolaryngol 2001;258:246–9CrossRefGoogle ScholarPubMed
14 De Santo, LW, Magrina, C, O'Fallon, WM. The second side of the neck in supraglottic cancer. Otolaryngol Head Neck Surg 1990;102:351–61CrossRefGoogle ScholarPubMed