ORIGINAL ARTICLE SUPRACRICOID PARTIAL LARYNGECTOMIES AFTER RADIATION FAILURE: A MULTI-INSTITUTIONAL SERIES Raul Pellini, MD, 1 Barbara Pichi, MD, 1 Paolo Ruscito, MD, 1 Alberto Rinaldi Ceroni, MD, 2 Umberto Caliceti, MD, 2 Giuseppe Rizzotto, MD, 3 Antonio Pazzaia, MD, 3 Pasquale Laudadio, MD, 4 Cesare Piazza, MD, 5 Giorgio Peretti, MD, 5 Diana Giannarelli, PhD, 6 Giuseppe Spriano, MD 1 1 Department of Otorhinolaryngology–Head and Neck Surgery, National Cancer Institute ‘‘Regina Elena’’, Rome, Italy. E-mail: barbapichi@libero.it 2 Department of Otorhinolaryngology, ‘‘Ospedale Sant’Orsola Malpighi’’, Bologna, Italy 3 Department of Otorhinolaryngology, ‘‘Ospedale Civile’’, Vittorio Veneto, Italy 4 Department of Otorhinolaryngology, ‘‘Ospedale Maggiore’’, Bologna, Italy 5 Department of Otorhinolaryngology, University of Brescia, Brescia, Italy 6 Biostatistical Unit, National Cancer Institute ‘‘Regina Elena’’, Rome, Italy Accepted 29 May 2007 Published online 30 October 2007 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/hed.20709 Abstract: Background. Radiation therapy (RT) is one of the gold standard treatments for early laryngeal cancer, and total laryngectomy is still the most applied surgical procedure after failure. Selected recurrences can be managed by supracricoid partial laryngectomies (SCPLs). Methods. A multi-institutional retrospective analysis was carried out in 78 consecutive patients treated by SCPLs for the recurrence of glottic-supraglottic cancer after RT. Cricohyoido- epiglottopexy was performed in 62, and cricohyoidopexy (CHP) in 16 cases. Results. Disease-free survival at 3 and 5 years were 95.5%. Early and late postoperative complications occurred in 27% and 17.9% of cases. Decannulation and satisfactory swallowing were achieved in 97.4% of cases. Conclusions. SCPLs represent effective surgical organ-pres- ervation strategies in the treatment of selected recurrences after RT failure, resulting in a good local control as well as functional recovery with acceptable morbidity, despite a complication rate which is not negligible. V V C 2007 Wiley Periodicals, Inc. Head Neck 30: 372–379, 2008 Keywords: laryngeal cancer; partial laryngectomy; supracricoid laryngectomy; radiation failure; organ preservation surgery In recent decades, refinement in treatment of laryn- geal cancer has increasingly focused on tumor eradi- cation and the progressive decrease of postoperative morbidity and permanent impairment of laryngeal functions. To avoid total laryngectomy as much as possible, organ-preservation chemoradiation proto- cols and conservative surgery have been used for pri- mary treatment of laryngeal cancer, reserving total laryngectomy as salvage treatment. 1–3 Local recurrence rate after radiation therapy (RT) ranges from 5% to 13% for T1 and from 25% to 30% for T2 laryngeal cancer. 4,5 Surgical man- agement of recurrences after RT failure encom- passes endoscopic laser excision, 6–8 partial lar- yngectomies through an open-neck approach, 4,9–13 and total laryngectomy, which still remains the most widely used procedure in such a scenario. 14–17 Correspondence to: B. Pichi V V C 2007 Wiley Periodicals, Inc. 372 Supracricoid Laryngectomy after Radiation Failure HEAD & NECK—DOI 10.1002/hed March 2008