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Introduction <p>Laryngeal cancer is a significant global health burden, with most cases originating in the glottic region. Total laryngectomy (TL) is often required for advanced stages, but it carries a high complication rate. This study evaluates the impact of various intraoperative and postoperative strategies implemented after 2008 on survival and complication outcomes in TL patients.</p> Material &amp; methods <p>This retrospective cohort study included 462 laryngeal cancer patients who underwent TL at an oncology reference center between 1986 and 2018. Patients were divided into two groups: “Before 2008” (n = 271) and “Post 2008” (n = 191). Data on demographics, clinical characteristics, complications, and survival outcomes were collected. Statistical analyses included Mann-Whitney, Chi-Square, and Kaplan-Meier methods.</p> Results <p>The complication rate decreased significantly in the “Post 2008” group − 129 (15.7%) vs. 30 (47.6%), p &lt; 0.000. Pharyngocutaneous fistula rates dropped from 34 (12.5%) to 11 (5.8%), p &lt; 0.05, and hypothyroidism rates from 41 (15.1%) to 3 (1.6%). Median hospital stay reduced from 16 to 10 days (p &lt; 0.000). Recurrence rates decreased from 90 (33.2%) to 46 (24.1%), p = 0.034. Median overall survival increased from 2.24 to 3.67 years (p = 0.037).</p> Discussion <p>Intraoperative strategies, including continuous neopharyngeal suturing and selective hemithyroidectomy, associated to postoperative measures, such as benzodiazepines prescription, vesical catheterization and tracheostomy tube avoidance, decreased complications and were associated to a greater overall survival.</p> Conclusions <p>The implemented strategies significantly improved overall survival, reduced complications, and shortened hospital stays for TL patients, highlighting their clinical efficacy in managing advanced laryngeal cancer.</p>

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Impact of implemented strategies on survival and complications in laryngectomized patients: a retrospective cohort study from an oncology reference center

  • 期刊论文

  • 发表日期：

    2025年10月24日

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  • Filipa Morgado,
  • Gonçalo Caetano,
  • Francisco Branquinho

摘要

Introduction

Laryngeal cancer is a significant global health burden, with most cases originating in the glottic region. Total laryngectomy (TL) is often required for advanced stages, but it carries a high complication rate. This study evaluates the impact of various intraoperative and postoperative strategies implemented after 2008 on survival and complication outcomes in TL patients.

Material & methods

This retrospective cohort study included 462 laryngeal cancer patients who underwent TL at an oncology reference center between 1986 and 2018. Patients were divided into two groups: “Before 2008” (n = 271) and “Post 2008” (n = 191). Data on demographics, clinical characteristics, complications, and survival outcomes were collected. Statistical analyses included Mann-Whitney, Chi-Square, and Kaplan-Meier methods.

Results

The complication rate decreased significantly in the “Post 2008” group − 129 (15.7%) vs. 30 (47.6%), p < 0.000. Pharyngocutaneous fistula rates dropped from 34 (12.5%) to 11 (5.8%), p < 0.05, and hypothyroidism rates from 41 (15.1%) to 3 (1.6%). Median hospital stay reduced from 16 to 10 days (p < 0.000). Recurrence rates decreased from 90 (33.2%) to 46 (24.1%), p = 0.034. Median overall survival increased from 2.24 to 3.67 years (p = 0.037).

Discussion

Intraoperative strategies, including continuous neopharyngeal suturing and selective hemithyroidectomy, associated to postoperative measures, such as benzodiazepines prescription, vesical catheterization and tracheostomy tube avoidance, decreased complications and were associated to a greater overall survival.

Conclusions

The implemented strategies significantly improved overall survival, reduced complications, and shortened hospital stays for TL patients, highlighting their clinical efficacy in managing advanced laryngeal cancer.