Abstract B39: Role of supracricoid partial laryngectomy in the aging era
Authors: Nam Inn-chul , Kim Choung-soo , Kim Keun-jeon , Kim MIn-sik 
Published: September 2020

Introduction: Supracricoid laryngectomy (SCL) is a conservative surgical technique for the treatment of selected laryngeal carcinomas, currently adopted also in old patients. But in the aging era, elderly patients represent the fastest-growing section of the population. The aim of this study is to compare the oncologic and functional results in elderly and younger patients following SCL.

Materials and Methods: We retrospectively reviewed the medical records of 114 patients who underwent SCL between 1994 and 2013. All of the patients underwent surgery at least 5 years before the study was undertaken. We took the cut-off age of elderly patients as 70 years old, and there were 15 elderly patients. We chose another 15 patients with age younger than 60 years who are matched in stage, primary site, and reconstruction methods. Patients older than 70 years were classified to group I, and patients younger than 60 years were classified to group II. In group 1, the mean age was 53.2 years of age (range 46-60), and in group 2 it was 73.3 years of age (range 71-77). Functional evaluation was performed by evaluating the time of decannulation and nasogastric tube removal, final diet, and duration of hospital stay. Patients’ voice quality was assessed perceptually using GRABS scale. Postoperative complications, especially pulmonary complication such as aspiration pneumonia, were also evaluated. Oncologic results were also evaluated in both groups.

Results: The total GRABS score of group I was 8.7 and that of group II was 7.3, and there was no significant statistical difference in these two values. The average time of decannulation was slightly longer in group I; however, these values were not significantly different. The average time of nasogastric tube removal and hospitalization time was significantly longer in group I patients. This was due to the longer duration of swallowing exercise. However, all patients could finally intake orally without gastrostomy. The rate of aspiration pneumonia was slightly higher in group I but failed to show statistical difference. All patients underwent surgery as a primary treatment mordality. In group I, one patient underwent adjuvant radiation, and two patients in group II underwent adjuvant radiation. The 5-year overall survival was 66.6%, 5-year disease-specific survival was 72.1%, and the survival rates of the two groups were not significantly different.

Conclusion: Age by itself does not have a significant impact on functional and oncologic results following SCPL. Though elderly patients need more time to take oral diet, that is, need longer time of swallowing exercise, they can finally intake oral diet after swallowing training. Meticulous selection of the candidate to SCPL allows the application of this surgical technique with adequate oncologic and functional results.

Citation Format: Inn-chul Nam, Choung-soo Kim, Keun-jeon Kim, MIn-sik Kim. Role of supracricoid partial laryngectomy in the aging era [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr B39.