The Surgical Indications and Limitations of Supracricoid Laryngectomy from the Perspective of the Resection Line

The simultaneous pursuit of functional preservation and a disease cure in supracricoid laryngectomy (SCL) for laryngeal cancer requires adequate case selection and resection with careful consideration of surgical indications and limitations. This article describes the resection line of SCL with specific examples and assesses the validity of this line in order to review the indications and limitations with regard to the resection line. The normal and critical resection lines are both defined at five sites in order of resection: anterior, superior, lateral, posterior, and inferior side of the larynx. In the present study, treatment outcomes were assessed in 30 patients with laryngeal cancer who underwent SCL, including 2 cases of supratracheal laryngectomy, in our hospital from March 2013 to February 2019. The 5-year overall survival, disease-free survival, and laryngeal function preservation rates were 92 .3%, 85 .2%, and 89.9%, respectively. These results supported the validity of the resection line we employed. Precisely understanding the resection line permits an adequate and flexible response to patients pre-and -intraoperatively and facilitates meeting the seemingly conflicting goals of functional preservation and a disease cure. Eventually, the number of patients to avoid total laryngectomy is expected to increase.