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Pre-operative tracheostomy does not impact on stomal recurrence and overall survival in patients undergoing primary laryngectomy

Research output: Contribution to journalArticle

Thomas F. Pezier, Iain J. Nixon, Anil Joshi, Leo Pang, Teresa Guerrero-Urbano, Richard Oakley, Jean-Pierre Jeannon, Ricard Simo

Original languageEnglish
Pages (from-to)1729-1735
Number of pages7
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume270
Issue number5
DOIs
Publication statusPublished - May 2013

King's Authors

Abstract

Pre-operative tracheostomy (POT) to secure a critical airway up to several weeks before definitive laryngectomy in patients with laryngeal cancer has been proposed as a risk factor for poor oncologic outcome. Few modern papers, however, examine this question. The aim of this study is therefore to determine whether POT affects oncologic outcome with an emphasis on stomal/peristomal recurrence. This is a retrospective case note review of 60 consecutive patients undergoing curative primary total laryngectomy (TL) for advanced laryngeal squamous cell carcinoma (SCC). Demographic, staging, treatment and outcome data were collected. 27/60 (45 %) patients had POT and 33/60 did not. No patient underwent laser debulking. Median age was 62 years (39-90 years) and median follow-up of survivors was 31 months. 5-year overall survival (OS), disease-specific survival (DSS) and local recurrence-free survival (LRFS) of patients undergoing POT versus no POT was 28 versus 39 % (p = 0.947), 55 versus 46 % (p = 0.201) and 96 versus 88 % (p = 0.324) respectively. No statistically significant difference in OS, DSS and LRFS was found between patients undergoing POT and those not. Despite the relatively small case series, this evidence should reassure surgeons without the ability to perform trans-oral debulking that they should not hesitate to perform tracheostomy on a patient with airway obstruction due to laryngeal cancer. Appropriate definitive treatment meant that POT was not a risk factor for poor oncological outcome in our series.

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