Larynx cancer treatment results: survive and quality of life assessment

OBJECTIVES: To make a contribution to the treatment modality of larynx cancer, we evaluated our surgical outcomes of the patients with larynx cancer and their quality of life in the postoperative period. PATIENTS AND METHODS: Forty-three patients (38 males, 5 females; mean age 57.6 years; range 34 to 84 years) with larynx cancer were included in this retrospective clinical study. Total laryngectomy/near total laryngectomy (TL/NTL) was performed in 29 patients, supracricoid laryngectomy in 13 patients and supraglottic laryngectomy in one patient. Neck dissection performed in 39 patients. Two patients had preoperative and eleven patients had postoperative radiotherapy (RT). The patients were evaluated with respect to age, sex, smoking, alcohol consumption, localization-differentiation-stage of the tumor, surgery and RT, postoperative complications and survival. QLQ-C30 and QLQ-H and N35 questionnaires were used and the results of 26 patients who were alive and filled in the questionnaires themselves were evaluated. RESULTS: The most frequent postoperative complication was pharyngocutaneous fistula (41.3%), which occurred only in TL/NTL patients. Mean postoperative hospitalization time was 21.2 days. Laryngeal preservation, peristomal recurrence and locoregional recurrence rates were 64.3%, 6.9% and 9.3% respectively. Overall survival rate was 88.8%. Mean survival time was 62.4 months. In quality of life assessment, speech problem (p<0.01) and cough index (p<0.05) were significantly higher in TL/NTL group than SCL group (p<0.05). There were no significant difference in both groups with respect to RT (p>0.05). CONCLUSION: Our surgical outcomes are compatible with the previous studies. Although the larynx preservation had a positive effect on the speech, it did not affect other quality of life parameters. In addition, having a permanent tracheostomy increased cough index markedly. We emphasize that multi-institutional prospective quality of life studies comparing different treatment methods for similar stage tumors are essential in defining the optimal management strategy in patients with larynx cancer.