Ahmed Nabil Elsamanody
1 
, Ahmed Seleim
1, Mohammed Abdelfattah Eltawy
1, Ahmed Seddik Abdelglil Mohammed
1, Sherif Azzam
2* , Eslam Mohamed M. Ibrahim
2 , Mohamed Abdelfattah
3, Mohamed Abd El-Rahman Alkenawy
3, Ahmed Seif Elnasr Sedeek
3, Mahmoud Mohamed Aboumandour Fouda
3 , Sameh Zayed
4,5 , Ashraf Y. Hegab
4,6 , Hashem Bark A. Abood
7 , Tamer A.A. Samih
8 , Hasan A. Soltan
9 1 Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
2 Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
3 Department of Radiodiagnosis and Intervention Radiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
4 Prince Mishari bin Saud Hospital in Baljurashi, Al-Baha Health Cluster, Ministry of Health, Al-Baha, Saudi Arabia
5 Department of Otorhinolaryngology, Ministry of Health, Cairo, Egypt
6 Department of Internal Medicine, Ministry of Health, Cairo, Egypt
7 Department of Surgery, King Fahad Hospital, Al-Baha Health Cluster, Ministry of Health, Al-Baha, Saudi Arabia
8 Department of Radiology, Faculty of Medicine, Benha University, Benha, Egypt
9 Department of Radiology, Faculty of Medicine, Aswan University, Aswan, Egypt
Abstract
Introduction: Locally advanced laryngeal squamous cell carcinoma often requires aggressive treatment. Total laryngectomy followed by radiotherapy remains a standard approach for achieving local control and improving survival when organ preservation is not feasible.
Objectives: To evaluate the morbidity and mortality outcomes of patients with locally advanced laryngeal cancer (LC) managed with total laryngectomy followed by postoperative radiotherapy (TLPR) at a tertiary hospital in Egypt.
Patients and Methods: This retrospective study included patients with a pathological diagnosis of T3 or T4 locally advanced LC treated with TLPR between 2017 and 2021, with a follow-up period of 33 months. Clinical and demographic variables, including age, gender, smoking status, tumor sub-site, TNM (tumor, node, metastasis) classification, clinical staging, pathological features, treatment modality, preoperative tracheostomy, postoperative fistula, and associated comorbidities, were collected and analyzed for their relationship to prognosis.
Results: A total of 84 patients were included in the study, with a mean age of 52.93 years (range: 26–82 years) and a male-to-female ratio of 68% to 32%. Among the patients, 45.2% achieved complete response, 28.5% had partial response, 16.8% experienced stable disease, and 9.5% showed disease progression. Frequent relapse occurred in 22 patients. The mean overall survival was 57.29 ± 62.14 weeks (range: 8–242 weeks), while the mean progression-free survival was 26.81 ± 40.92 weeks (range: 6–225 weeks).
Conclusion: Postoperative radiotherapy following total laryngectomy is an effective strategy for achieving better disease control and long-term survival in patients with locally advanced laryngeal squamous cell carcinoma.