Kazutake Yagi, Takayuki Imai, Ayako Nakanome, Yuya Miyakura, Kento Sasaki, Akira Ohkoshi, Yukinori Asada, Yukio Katori
FLVPL provided favorable oncological control with excellent postoperative swallowing in selected patients with cT3N0 glottic carcinoma and no vocal cord fixation or invasion of the thyroid cartilage. This procedure may be a valuable larynx-preserving surgical option in carefully selected T3 cases.
OBJECTIVE: To evaluate oncological and functional outcomes of frontolateral vertical partial laryngectomy (FLVPL) in carefully selected patients with cT3N0 glottic carcinoma.
METHODS: We retrospectively reviewed consecutive patients with cT3N0 glottic carcinoma who underwent FLVPL as their primary treatment at a single institution between January 2014 and December 2024. Survival outcomes, including overall survival, disease-specific survival, disease-free survival, and laryngectomy-free survival, were analyzed using the Kaplan-Meier method. Postoperative functional outcomes were also assessed.
RESULTS: Sixteen patients were included (median follow-up, 31 months). All tumors showed invasion of the paraglottic space without vocal cord fixation or invasion of the thyroid cartilage. There were five recurrences, two of which were local and required salvage total laryngectomy. The final laryngeal preservation rate was 87.5%. The 3-year overall, disease-specific, disease-free, and laryngectomy-free survival rates were 92.3%, 100%, 57.9%, and 73.9%, respectively. Oral intake resumed at a median of 5 days postoperatively, and all patients achieved oral feeding without long-term tube dependence.
CONCLUSION: FLVPL provided favorable oncological control with excellent postoperative swallowing in selected patients with cT3N0 glottic carcinoma and no vocal cord fixation or invasion of the thyroid cartilage. This procedure may be a valuable larynx-preserving surgical option in carefully selected T3 cases.