Post-laryngectomy stomal cancer recurrences, re-treatment decisions and outcomes: Case series

Objective: Post-laryngectomy stomal cancer recurrences pose management problems because aggressive therapeutic interventions have already often been employed. The purpose of this study is to describe the extent of peristomal cancer relapses, treatment decisions and patient outcomes. Methods: Of the 429 individuals who underwent total laryngectomy for laryngeal cancer between 1985 and 2005, 11 patients developed recurrent tumour in the tracheal stoma. Results: Using Sisson's disease classification, the lesions were assigned as type I [5 patients], II [2 patients], III [1 patient.] or IV [3 patients]. Combined therapy or re-irradiation alone was administered more often to individuals with early stage disease than to patients with type III or IV recurrences. Complete resolution with local control of tumour occurred in two patients. The overall 2-year survival rate was 10%, and the median survival with and without repeated treatment was I I months and 7 months, respectively. Conclusion: Re-treatment deserves consideration in individuals with post-laryingectomy stomal cancer recurrences because salvage therapy could truly rescue patients, and progressive tracheostomal obstruction or massive hemorrhage invariably develops if the tumours are left untreated. (C) 2009 European Association for Cranio-Maxillofacial Surgery