Open partial laryngectomy after failure of (chemo) radiation: indications, oncologic and functional outcomes

Purpose of review: Early-stage squamous cell carcinoma of the larynx can be successfully treated with radiotherapy or surgery (transoral or open approaches). Oncologic results are comparable while functional results may be different according to the volume of resection. In some countries radiotherapy is often preferred as primary treatment. In case of recurrence, surgical salvage is the only option. Careful examination, endoscopic assessment, computed tomography or magnetic resonance imaging are necessary to assess superficial and deep extensions into the larynx, including cartilage framework and to restage the tumor. Recent findings: The choice between endoscopic and open partial laryngectomy is based on the extension and characteristics of the tumor. Oncologic results of open approaches are encouraging as local control, survival, and laryngeal preservation rates reported in the literature are close to those obtained in nonpreviously treated patients. Functional results are not significantly worse and major complications in the previously irradiated patients undergoing open neck surgery not increased. Supracricoid partial surgery seems to be more and more performed. Summary: With regards to the results, open partial surgery, like in nonpreviously treated patients, is still indicated for the surgical treatment of postradiotherapic recurrent/persistent disease.

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