Benefits and drawbacks of open partial horizontal laryngectomies, Part A: Early-intermediate stage glottic carcinoma

Background. Laryngeal squamous cell carcinoma (SCC) accounts for 1.9% of cancers worldwide. Most of these are diagnosed in the early stages (T1-T2, N0). For these, a larynx preserving/conserving option is preferable. Beyond transoral laser microsurgery (TLM), open partial horizontal laryngectomy (OPHL) is a function-sparing surgical technique used to treat laryngeal SCC. Methods. We retrospectively analyzed the clinical outcomes of 216 patients who underwent OPHL for glottic cT2 laryngeal cancer. Results. Five-year overall survival, disease-specific survival, locoregional control, local control, laryngeal function preservation, and laryngectomy-free survival rates were 93.1%, 98.0%, 97.1%, 97.5%, 97.8% and 98.5%, respectively. Disease controls were significantly affected by previous treatment and type of surgery employed. Conclusions. Although TLM for cT2 laryngeal cancer with unimpaired vocal cord mobility still represents a sound option, OPHL offers higher local control and laryngeal preservation rates for selected patients with impaired mobility of vocal cords combined with involvement of the paraglottic space.