Organ preservation surgery in patients with locally advanced laryngeal cancer


Aim. To improve the results of treatment of patients with locally advanced laryngeal cancer by developing organ preservation surgery combined with radiation therapy.

Methods. 20 patients with locally advanced laryngeal cancer stage III (T3N0-1M0) were examined. A surgery was developed that involves lateral resection of the larynx in conjunction with the underlying thyroid cartilage, preserving its upper 1/3-1/4 portion as a horizontal plate not affected by a tumor. On the affected side of the neck, a skin flap is preliminarily harvested, by 1.5-1.0 cm longer and wider than the resulting laryngeal defect. It is put over the fragment of thyroid cartilage left after resection and sutured to the healthy mucosa of the preserved part of the larynx. Laryngostomy and tracheostomy are formed. Tracheostomy tube is inserted. Formed laryngostomy is freely tamponed with two to three tampons with an antiseptic solution for up to 7 days. Naso-esophageal probe is inserted. Patients who did not receive radiation treatment before surgery, receive postoperative gamma-therapy after 14-20 days with cumulative dose up to 40 Gy. Plastic surgery of laryngostomy and tracheostomy is performed after 4-5 months after the intervention.

Results. The developed method of surgery for patients with stage 3 of one half of the larynx allowed a radical removal of the tumor with the restoration of breathing, swallowing and speech. The event-free 5-year survival rate was 80±4.5%, and the total 3-year survival was 100%. Сonclusion. The developed technique of organ-preserving surgery in patients with locally advanced laryngeal cancer stage 3 involving its one half can provide oncological radical technique with the rehabilitation of the functions of the larynx.

P V Svetitskiy

Rostov Research Institute of Onclogy

Author for correspondence.
Rostov-on-Don, Russia

V L Volkova

Rostov Research Institute of Onclogy

Rostov-on-Don, Russia

I V Aedinova

Rostov Research Institute of Onclogy

Rostov-on-Don, Russia

  1. Paches A.I. Opukholi golovy i shei. (Tumors of the head and neck.) 4th ed. Moscow: Medicine. 2000; 480 p. (In Russ.)
  2. Zlokachestvennye novoobrazovaniya v Rossii v 2013 godu. (Malignant neoplasms in Russia in 2013.) Ed. by A.D. Kaprin, V.V. Satrinskiy, G.V. Petrova. Moscow: MNIOI im. A.P. Gertsena. 2015; 14. (In Russ.)
  3. Davydov M.I., Aksel’ E.M. The structure of the prevalence of malignant neoplasms and the detection of patients during preventive examinations. The statistics of malignant neoplasms in Russia and the CIS countries. Vestnik RONTs im. N.N. Blokhina RAMN. 2011; 22 (3, suppl. 1): 46. (In Russ.)
  4. Kit O.I., Duritsky M.N., Shelyakina T.V., Engibaryan M.A. Features of detectability of oncological diseases of the head and neck organs in the conditions of an oncological institution and establishment of a general medical network. Sovremennye problem nauki i obrazovaniya. 2015; 4. (access date: 11.10.2018). (In Russ.)
  5. Svetitskiy P.V., Kirtbaya D.V., Volkova V.L. The me­thod of reconstructive surgery on the larynx. Patent for invention RF №2463967. Bulletin №29 issued on 20.10.2012. (In Russ.)
  6. Калий В.В., Светицкий П.В., Волкова В.Л. Реконструктивные операции у больных местно-распространённым раком гортани. Кубанский науч. мед. вестн. 2010; (2): 37–38. [Каliy V.V., Svetitskiy P.V., Volkova V.L. Reconstructive operatioios in patients with locally advanced laryngeal cancer. Kubanskiy nauchnyy meditsinskiy vestnik. 2010; (2): 37–38. (In Russ.)]


Abstract - 23

PDF (Russian) - 40


© 2019 Svetitskiy P.V., Volkova V.L., Aedinova I.V.

Creative Commons License

This work is licensed
under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Свидетельство о регистрации СМИ ЭЛ № ФС 77-75008 от 1 февраля 2019 года выдано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор)