A Study on Vertical Partial Laryngectomy for Glottic Cancer: —Clinical Management After Failure of a Full Course of Radiotherapy—

We performed a retrospective study of 12 patients with glottic cancer who underwent vertical partial laryngectomy at the Department of Otolaryngology, St. Marianna University School of Medicine, from April 2008 to March 2018. All patients were male, with a median age of 64.5 years (range 40–79 years). The median follow-up period was 109 months (range 20–134 months). Vertical partial laryngectomy was performed as salvage surgery after failure of a full course of radiotherapy. Local recurrence occurred in 2 patients after vertical partial laryngectomy, but they were salvaged by subsequent total laryngectomy. Swallowing dysfunction occurred in 1 patient after vertical partial laryngectomy, and this patient was also treated by subsequent total laryngectomy. The 5-year overall survival rate of patients treated by vertical partial laryngectomy as salvage surgery was 91.7%. The 5-year larynx preservation rate after salvage vertical partial laryngectomy was 75.0%. The 5-year local control rate after salvage vertical partial laryngectomy was 81.8%. Thus, vertical partial laryngectomy for glottic cancer is useful as salvage surgery after failure of a full course of radiotherapy in patients with glottic cancer. Subglottic extension and paraglottic space invasion might be risk factors for local recurrence and swallowing disorder after salvage vertical partial laryngectomy. Diagnosis of extension of recurrent tumor in the anterior commissure manifesting as ulcer formation was very difficult. We performed laryngomicrosurgery (LMS) prior to salvage surgery in all patients who were suspected as having developed local recurrence after radiation failure for glottic cancer. In addition, we carried out intraoperative frozen section diagnosis during salvage surgery in glottic cancer patients with local recurrence after radiation failure. LMS and intraoperative frozen section diagnosis were important for local control of recurrent tumor after radiation failure in patients with glottic cancer.