J. Pies, S. Hackenberg, M. Scheich, T. Meyer, A. Scherzad, M. Goncalves

RWTH Aachen University, Aachen, Germany. juliapies@gmx.de

OBJECTIVE: Open partial laryngectomy (pLE), in cases not suited for transoral resection, aims to provide an oncologically safe resection, maintaining laryngeal function without the need for permanent tracheostomy. In cases requiring extensive resection, debate remains about whether pLE is feasible with a functional outcome or if total laryngectomy (tLE) is preferable.

MATERIALS AND METHODS: This monocentric retrospective cohort study evaluated the resection of locally advanced (T3, T4) laryngeal carcinoma (LC) performed via open pLE or tLE between November 2010 and August 2023. Transoral resections, T1 and T2 cases were excluded. The presence of tracheostomy, the rate of oral feeding, the ability to phonate, and the oncologic outcome were assessed.

RESULTS: The outcome of 38 pLEs and 56 tLEs was assessed. Adjuvant therapy was administered in 76% (n=29/38) pLEs and 47% (n=26/56) tLEs. While the oncologic results remained comparable between the two procedures (negative margins: p = 0.349; 5-year overall survival: p = 0.421), total laryngectomy (tLE) achieved better functional outcomes. Swallowing ability was markedly better after tLE (pLE vs. tLE: 39.5% vs. 91%, p < 0.001), particularly in patients with T4 tumors (pLE vs. tLE: 14% vs. 89%, p < 0.001) and in those over 65 years (pLE vs. tLE: 14% vs. 100%; p < 0.001). Overall, aspiration was the most frequent post-therapeutic complication after pLE, preventing unassisted oral intake in 58% of cases (22/38). The tracheostomy could be closed in 26% (n=10/38) of pLE-patients, at a median of 6.57 months (range 0.6-24 months). Consequently, after pLE 74% (n=28/38) of patients retained their tracheostomy at a median follow-up of 4 years.

CONCLUSIONS: The low rates of tracheostoma closure, low rates of oral feeding over a median of 4 years, and R0 resection status of T4 tumors after pLE compared to tLE suggest patients with locally advanced LC are better suited for tLE.

Graphical Abstract
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License To cite this article

J. Pies, S. Hackenberg, M. Scheich, T. Meyer, A. Scherzad, M. Goncalves
Retrospective comparison of functional outcomes in open partial laryngectomy vs. total laryngectomyfor locally advanced (T3, T4) laryngeal cancer

Eur Rev Med Pharmacol Sci
Year: 2025
Vol. 29 - N. 6
Pages: 289-300
DOI: 10.26355/eurrev_202506_37271

Publication History

Submission date: 12 Mar 2025

Revised on: 01 Apr 2025

Accepted on: 05 Jun 2025

Published online: 30 Jun 2025