Benefits and drawbacks of open partial horizontal laryngectomies, Part B: Intermediate and selected advanced stage laryngeal carcinoma

BACKGROUND: Cancer of the larynx in the intermediate/advanced stage still presents a major challenge in terms of controlling the disease and preserving the organ. Among therapeutic options, open partial horizontal laryngectomy (OPHL) is proposed as a function-sparing surgical technique. METHODS: We analyzed the clinical outcomes of 555 patients with laryngeal cancer staged pT3-pT4a who underwent OPHL. RESULTS: 5-year overall survival, disease-free survival, locoregional control, local control, laryngectomy-free survival and laryngeal function preservation rates were 84.6%, 84.2%, 86.3%, 90.6%, 93.3% and 91.2%, respectively. Disease-free survival, locoregional control and laryngeal function preservation rates were significantly affected by pT4a staging (68.1%, 71.7% and 78.0% respectively), while pN+ influenced only disease-free survival (≤72.6%) and locoregional control (≤79.6%). CONCLUSIONS: OPHL with a modular approach can be considered effective in terms of prognostic and functional results in intermediate stage and selected advanced stage laryngeal cancers, even with subglottic extension