Our Summary

This research paper examines the outcomes of a specific surgical procedure, called partial glottic-subglottic laryngectomy (GSL), used to treat laryngeal cancer. The researchers looked at the medical records of patients who had this surgery at a specific hospital between 1989 and 2020.

They found that 36 patients had the procedure for laryngeal cancer. The types of cancer varied, with 16 cases of squamous cell carcinoma, 9 cases of adenoid-cystic carcinoma, 8 cases of laryngeal chondrosarcoma, and one case each of giant cell carcinoma, carcinosarcoma, and colon adenocarcinoma metastasis.

In terms of results, for the patients with squamous cell carcinoma, about a third experienced a recurrence of their cancer, but the overall survival rate was 75%. For those with adenoid-cystic carcinoma, about a quarter had a recurrence, but the survival rate was higher at 88%. For patients with chondrosarcoma, no relapses were reported and the survival rate was 100%. For those patients who did not experience a recurrence, 75% were able to have their breathing tube removed permanently.

The authors conclude that GSL is a good alternative to total removal of the larynx in certain cases of laryngeal cancer affecting the glottic and subglottic regions.

FAQs

  1. What is a partial glottic-subglottic laryngectomy (GSL)?
  2. What were the survival rates found in the study for different types of laryngeal cancer treated with GSL surgery?
  3. Can the breathing tube be removed permanently after a GSL surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laryngectomy is to be prepared for changes in their voice and swallowing function after the surgery. Speech therapy and swallowing therapy can be very beneficial in helping patients adjust to these changes and improve their communication and ability to eat and drink. It is important for patients to work closely with their healthcare team to address any concerns or difficulties they may have post-surgery.

Suitable For

Patients who are typically recommended for laryngectomy include those with laryngeal cancer that is localized to the glottic and subglottic regions, as well as those who have failed other treatments such as radiation therapy or chemotherapy. Additionally, patients who have tumors that are invading nearby structures and cannot be removed completely with other treatments may also be good candidates for laryngectomy. It is important for patients to discuss their specific case with their healthcare team to determine if laryngectomy is the best treatment option for them.

Timeline

Before laryngectomy:

  1. Patient is diagnosed with laryngeal cancer through imaging tests and biopsies.
  2. Patient undergoes various treatments such as radiation therapy and chemotherapy to shrink the tumor.
  3. If the tumor is not responding to other treatments or is too large, the patient may be recommended for laryngectomy.
  4. Patient undergoes pre-operative assessments and consultations to prepare for the surgery.

After laryngectomy:

  1. Patient undergoes the surgical procedure to remove part or all of the larynx.
  2. Patient may need a tracheostomy tube to help with breathing post-surgery.
  3. Patient undergoes speech therapy to learn how to speak without a larynx.
  4. Patient may receive additional treatments such as radiation therapy or chemotherapy to prevent recurrence of cancer.
  5. Patient undergoes regular follow-up appointments and scans to monitor for any signs of cancer recurrence.
  6. Patient may experience changes in their quality of life, including difficulties with breathing, speaking, and swallowing.
  7. Patient may need to make adjustments to their diet and lifestyle to accommodate for these changes.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laryngectomy include:

  • What are the potential risks and complications associated with laryngectomy surgery?
  • How will laryngectomy surgery affect my ability to speak and swallow?
  • What kind of rehabilitation or therapy will I need after laryngectomy surgery?
  • Will I need a breathing tube after laryngectomy surgery, and if so, for how long?
  • What kind of lifestyle changes will I need to make after laryngectomy surgery?
  • How often will I need follow-up appointments after laryngectomy surgery?
  • Are there any alternative treatments or procedures for laryngeal cancer that I should consider?
  • What is the expected outcome or prognosis for someone undergoing laryngectomy surgery for laryngeal cancer?
  • How many laryngectomy surgeries have you performed, and what is your success rate?
  • Can you provide me with information about support groups or resources for individuals who have undergone laryngectomy surgery?

Reference

Authors: Bertolin A, Lionello M, Baldovin M, Ghirardo G, Rizzotto G. Journal: J Surg Oncol. 2022 Feb;125(2):145-150. doi: 10.1002/jso.26675. Epub 2021 Sep 20. PMID: 34542917