PERISTOMAL RECURRENCE AFTER TOTAL LARYNGECTOMY
1Dokuz Eylül Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz ve Baş Boyun Cerrahisi Anabilim Dalı, İzmir, Türkiye2Dokuz Eylül Üniversitesi Tıp Fakültesi, Radyasyon Onkolojisi Anabilim Dalı, İzmir, Türkiye
3Dokuz Eylül Üniversitesi Tıp Fakültesi, Patoloji Anabilim Dalı, İzmir, Türkiye Objective: The aim of this study is to determine the risk factors that contribute peristomal recurrence development and to discuss the preventive measures regarding protection by analyzing clinical and pathologic findings of the patients with peristomal recurrences following total laryngectomy.
Material and Methods: The records of 145 patients undergoing total laryngectomy due to squamous cell carcinoma of the larynx were reviewed retrospectively and the patients who developed peristomal recurrences were determined. The effects of some clinicopathologic features on development of peristomal recurrence such as; laryngeal location of the tumor, subglottic extension of the tumor, preoperative tracheotomy avalibility and duration of the tracheotomy existence, presence of metastatic paratracheal lymph nodes, positivity of the surgical margins and reception of adjuvant radiotherapy were investigated.
Results: Eight patients (5,5 %) developed peristomal recurrences. The mean duration between the day of total laryngectomy and peristomal recurrence was 10,7 months. The subglottic extension of the tumor was statistically associated with increased risk of peristomal recurrence development (p=0.001), whereas no statistically significant association was shown in other parameters (p>0.05). No statistically significant difference was found in duration of tracheotomy existence between the patients with and without peristomal recurrences (p=0.25). Histopathologically aproved subglottic extension was seen in all patients with peristomal recurrences. Two patients with preoperative tracheotomy and evident subglottic extension of the tumor who did not receive adjuvant radiotherapy developed peristomal recurrences.
Conclusion: Our study showed that the coexistence of preoperative tracheotomy and histopathologically aprooved subglottic extension of the tumor is the major risk factor regarding peristomal recurrence development and adjuvant radiotherapy is mandatory in that patient group.
Keywords : Larynx carcinoma, peristomal recurrence, total laryngectomy, subglottic extension