الفهرس 
Five years’ experience of salvage laryngectomy at National Cancer Institute, Egypt
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Abstract
OBJECTIVES: To evaluate the rate of failure after primary treatment (chemo radiation) and conservative laryngeal surgery, to evaluate the rate of success of salvage laryngectomy, to delineate outcome of salvage laryngectomy. STUDY DESIGN: Retrospective review. METHODS: 43 patients underwent salvage laryngectomy at the Surgical Oncology Department, National Cancer Institute, Cairo University from January 2010 to December 2014. Overall interval to recurrence (ITR) was 9 months. 66.5% of the patients were free of disease at 2 years post-SL. Overall survival at 3 years was 58.4%. RESULTS: 40 patients had history of smoking (93%). Patients who received concomitant chemoradiotherapy as a 1ry treatment were 24 (55.8%). Radical radiotherapy as a 1ry treatment was delivered to 16 patients (37.2%).Radical radiotherapy as a 1ry treatment was delivered to 16 patients (37.2%). Salvage total laryngectomy was done in 39 patients (90.7%), salvage vertical hemilaryngectomy in 2 patients with glottis cancer (4.6%) and salvage total laryngo pharyngectomy in 2 patients (4.6%). Closure of the pharynx was primary in 27 patients (62.8%) and was augmented by myo/fascio-cutaneous flap in 16 patients (37.2%). 25 patients out of 43 (58.1%) underwent a lateral neck dissection. Salivary fistula occurred in 12 patients. There was 1 perioperative death. CONCLUSION: Proper selection of laryngeal cancer patients{u2019} i.e disease stage, compliance of patient, to be included in laryngeal preservation therapy is of prime importance to get the maximum benefit from treatment. Follow up of paients who were subjected to different organ preservation protocols of therapy should be strictly followed radiologically and by endoscope for early detection of any residual or recurrence disease. Salvage laryngectomy should be combined with antero-lateral neck dissection; unilateral or bilateral. The addition of pedicled or free flap should be considered for this patient population who undergo STL after chemoradiotherapy