Skip to main content

Impact of preoperatative tracheostomy on tracheostome recurrence and overall survival in patients undergoing laryngectomy

En

Abstract

Background

The development of tracheostomerecurrence after total laryngectomy is a complication with a dismal prognosis. The average survival rate of tracheostome recurrence (TR) is 7.5%, ranging from 1.7% to 40%The TR consists of diffuse infiltration of tumor into the soft tissues of the neck and mediastinum; hence the control of this disease is difficult.

Objective

To analyze the impact of preoperative tracheostomy ontracheostome recurrence (TR), regional recurrence (RR), and overall survival (OS) in patients undergoing primary laryngectomy.

Material and methods

Thirty three consecutive patients, who underwent primary total laryngectomy for locally advancedlaryngeal squamous cell carcinoma, were enrolled in this study. Patients whounderwent primary chemo-radiotherapy, partial laryngectomyor those treated palliatively wereexcluded from the study. Patient factors analyzed included age, gender, primarytumor site, TNM classification, type of procedure, thyroid gland management, extent of neck dissection and preoperative tracheostomy (POT). The timeinterval between tracheostomy and definitive surgery was calculated.

Results

A total of 33 patients underwent total laryngectomy(TL) for squamous cell carcinoma of the larynx. Thirty patients (90.9%) were males, while 3 (9.1%) patients were females. Their mean age was 57.7 (±11.6) years, 26 (78.8%) of them were smokers, their follow up mean time was 23 (±6.6) months. Tracheostomy recurrence occurred in 3 (9.1%) patients and regional recurrence in another 3(9.1%) patients. The 2 years survivalfor the whole patients was 84.8% and overall survival was 81.1%. Nineteen patients had POTbetween 10 to 21days (median 15)prior to TL surgery. Fourteen patients had their tracheostomy at the time of surgery. There was no statistical significant difference between both groups as regard overall survival, stomal recurrence and regional recurrence.

Conclusion

Our results are in keeping with more recent studies, which suggest that POT is notnecessarily related to stomal recurrence or poor oncological outcome.

References

  1. Keim WF, Shapiro MJ, Rosin HD. Study of postlaryngectomy stomal recurrence. Arch Otolaryngol 1965; 81: 183–186.

    Article  CAS  Google Scholar 

  2. Leon X, Quer M, Burgues J, Abello P, Vega M, de Andres L. Prevention of stomal recurrence. Head Neck 1996; 18: 54–59.

    Article  CAS  Google Scholar 

  3. Zbaren P, Greiner R, Kengelbacher ML. Stoma recurrence after laryngectomy: an analysis of risk factors. Otolaryngol Head Neck Surg 1996; 114: 569–575.

    Article  CAS  Google Scholar 

  4. Kowalski LP, Rinaldo A, Robbins KT, Pellitteri PK, Shaha AR, Weber RS, et al. Stomal recurrence: pathophysiology, treatment and prevention. Acta Otolaryngol 2003; 123: 421–432.

    Article  Google Scholar 

  5. Davis RK, Shapshay SM. Peristomal recurrence: pathophysiology, prevention and treatment. Otolaryngol Clin North Am 1980; 13: 499–508.

    Article  CAS  Google Scholar 

  6. Esteban F, Moreno JA, Delgado-Rodriguez M, Mochon A. Risk factors involved in stomal recurrence following laryngectomy. J Laryngol Otol 1993; 107: 527–531.

    Article  CAS  Google Scholar 

  7. Bignardi L, Gavioli C, Staffieri A. Tracheostomal recurrences after laryngectomy. Arch Otorhinolaryngol 1983; 238: 107–113.

    Article  CAS  Google Scholar 

  8. Still PM. Etiology of laryngeal and pharyngeal cancer. Ned Tijdschr Geneeskd 1971; 115: 1673–1675.

    Google Scholar 

  9. Petrovic Z, Djordjevic V. Stomal recurrence after primary total laryngectomy. Clin Otolaryngol Allied Sci 2004; 29: 270–273.

    Article  CAS  Google Scholar 

  10. Rubin J, Johnson JT, Myers EN. Stomal recurrence after laryngectomy: interrelated risk factor study. Otolaryngol Head Neck Surg 1990; 103: 805–812.

    Article  CAS  Google Scholar 

  11. Imauchi Y, Ito K, Takasago E, Nibu K-I, Sugasawa M, Ichimura K. Stomal recurrence after laryngectomy for squamous cell carcinoma of the larynx. Otolaryngol Head Neck Surg 2002; 126: 63–66.

    Article  Google Scholar 

  12. Rockley TJ, Powell J, Robin PE, Reid APL. Post-laryngectomystomal recurrence: tumor implantation or paratracheal lymphatic metastasis?. Clin Otolaryngol 1991; 16: 43–47.

    Article  CAS  Google Scholar 

  13. Yotakis J, Davris S, Kontozoglou T, Adamopoulos G. Evaluation of risk factors for stomal recurrence after total laryngectomy. Clin Otolaryngol 1996; 21: 135–138.

    Article  CAS  Google Scholar 

  14. Modlin B, Ogura JH. Post-laryngectomy tracheal stomal recurrences. Laryngoscope 1969; 79: 239–250.

    Article  CAS  Google Scholar 

  15. Reséndiz-Colosia JA, Gallegos-Hernández JF, Hernández-San Juan M, Barroso-Bravo S, Flores-Díaz R. Post total laryngectomy stomal recurrence. Case report and review of the literature. Cir Cir 2003; 71: 387–390.

    PubMed  Google Scholar 

  16. Sisson GA, Bytell DE, Becker SP. Mediastinal dissection: indications and newer techniques. Laryngoscope 1977; 87: 751–759.

    Article  CAS  Google Scholar 

  17. Abdul Rashid NH, Yunus MR, bte Baki MM, bte Ami M, Athar PP. Stomal recurrence after total laryngectomy: a 10-year review in Universiti Kebangsaan Malaysia Medical Center. J Pak Med Assoc 2012; 62:466–469.

    Google Scholar 

  18. Breneman JC, Bradshaw A, Gluckman J, Aron BS. Prevention of stomal recurrence in patients requiring emergency tracheostomy for advanced laryngeal and pharyngeal tumors. Cancer 1988; 62: 802–805.

    Article  CAS  Google Scholar 

  19. Pezier TF, Nixon IJ, Joshi A, Pang L, Guerrero-Urbano T, Oakley R, et al. Pre-operative tracheostomy does not impact on stomal recurrence and overall survival in patients undergoing primary laryngectomy. Eur Arch Otorhinolaryngol 2012; 270: 1729–1735.

    Article  Google Scholar 

  20. Halfpenny W, McGurk M. Stomal recurrence following temporary tracheostomy. J Laryngol Otol 2001; 115: 202–204.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tarek A. Hamdy.

Additional information

Conflicts of interest

There are no conflicts of interest.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Taha, M.S., Sabra, R., Hamdy, T.A. et al. Impact of preoperatative tracheostomy on tracheostome recurrence and overall survival in patients undergoing laryngectomy. Egypt J Otolaryngol 30, 332–336 (2014). https://doi.org/10.4103/1012-5574.144966

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1012-5574.144966

Keywords