Organ-saving surgical treatment of locally advanced and recurrent laryngeal cancer

Introduction. Treatment of locally advanced laryngeal cancer is a complex problem and should be aimed at saving the organ. Chemoradiation therapy is ineffective in 30 % of cases. Oncological outcomes of surgical treatment are better than outcomes of conservative methods, but the patient loses the larynx. Therefore, organ-saving surgical intervention in the form of various types of extended resections of the larynx depending on the location of the tumor remains an important problem of clinical oncology.Aim. To analyze the results of extended resections of the larynx as a method of organ-saving surgical treatment of patients with locally advanced and recurrent laryngeal cancer depending on tumor location, advancement, and previous treatment.Materials and methods. The study included 67 patients with locally advanced and recurrent laryngeal cancer who underwent extended resections of the larynx using techniques developed at the N. N. Blokhin National Medical Research Center of Oncology with the aim of performing organ-saving treatment. Stages of performing various extended resections of the larynx depending on tumor location are presented. Retrospective analysis of data on 37 patients who were followed up for 5 or more years was performed, clinical progression of the disease is discussed, and 5‑year recurrence-free and overall survival are presented, as well as the results of functional and social rehabilitation of the patients.Results. Between 2010 and 2025 at the N. N. Blokhin National Medical Research Center of Oncology, 67 patients with stage III–IVa cancer or tumor recurrence after previous unsuccessful treatment underwent various extended resections of the larynx depending on tumor location. After organ-saving surgical intervention, in all 67 patients rehabilitation of all functions of the organ with restoration of the separation biomechanics (between breathing and swallowing), breathing, vocalization was achieved at the level sufficient for social and labor rehabilitation. The five-year overall and disease-free survival rates were 89.2 and 87.1 %, respectively.Conclusion. The obtained data demonstrate the effectiveness of extended resections of locally advanced and recurrent laryngeal cancer. After surgery, the patients are fully functionally and socially rehabilitated without compromising oncological results which are similar to the results of laryngectomy.