STOMAL RECURRENCE AFTER LARYNGECTOMY: CLINICAL AND PATHOLOGICAL ANALYSIS

Stomal recurrence (SR) is one of the most serious complications occuring in patients treated for laryngeal carcinoma. The appearence of SR is an omnious prognostic sign for survival of the host and is usually refractory to any form of treatment modality. Out of a total of 578 laryngectomies performed and followed in the Department of Otorhinolaryngology at Istanbul Medical Faculty, Istanbul University from 1988 to 2000, fourteen patients with SR were reviewed. The paramaters included in the analysis were age, sex, initial T (tumor) and N (nodal) status, sites of tumor involvement in larynx, preoperative tracheostomy, initial operation, recurrence appearance period, Sisson stage, recurrence management, recurrence histology, tumor differentiation, areas of recurrence involvement and the end status of the patient. Subglottic involvement and advanced stage of tumors were most prominent features of all patients. According to Sisson stage, one but all patients with Sisson I and II survive. Recurrent tumor involvement in mediastine, pleura, cervical esophagus and clavicle were found to be bad prognostic signs in these cases. Because of diffuculty in management and adverse prognostic implication of this deadly complication, prophylactic surgery and irradiation are suggested to prevent SR.

Keywords: laryngeal carcinoma, laryngectomy, stomal recurrence, prognostic factors