Carbon dioxide laser salvage surgery after radiotherapy failure in T1 and @entity18906 XXXX .

@entity1 @entity189 @entity18906 @entity515
OBJECTIVES: Recurrent @entity189 after radiotherapy (RT) may be managed by open neck or endoscopic surgery. The impact of endoscopic treatment with @entity515 laser for recurrent @entity189 after RT is reported. METHODS: We present the oncologic and vocal outcomes of a retrospective study based on a series of 16 @entity1 with rT1 and @entity18906 @entity189 who were endoscopically managed between February 1995 and December 1999 after RT failure. All @entity1 were males with a mean age of 68.7 years (range, 50 to 87 years). Before RT, the lesions had been staged as T1 N0 in 11 @entity1 and @entity18906 N0 in 5, and after RT as rT1 N0 in 12 and @entity18906 N0 in 4. According to the European Laryngological Society classification, a total of 9 transmuscular, 3 total, and 4 extended cordectomies were performed. Mean follow-up was 45 months (range, 9 to 79 months). RESULTS: Endoscopic salvage surgery was successful in 14 @entity1 . One of them developed a second recurrence and was definitively cured with an additional endoscopic procedure. Two of the 16 @entity1 had recurrent disease after salvage laser surgery and died due to progression of disease. Ultimate local control with laser alone at 3 years was 87.1%, according to the Kaplan-Meier method. Laryngeal preservation was obtained in all survivors after endoscopic rescue surgery. Voice analysis showed a clear correlation between the amount of vocal cord tissue resected and decrease of the vocal outcome. CONCLUSIONS: The present series indicates that selected recurrences after primary RT for T1 and @entity18906 @entity189 are eligible for endoscopic salvage surgery with oncologic results comparable to those with open neck procedures but with a lower complication rate and a favorable functional outcome.
