ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Impact of implemented strategies on survival and complications in laryngectomized patients: a retrospective cohort study from an oncology reference center.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionLaryngeal 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 &
methodsThis 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.
resultsThe 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.
conclusionsThe implemented strategies significantly improved overall survival, reduced complications, and shortened hospital stays for TL patients, highlighting their clinical efficacy in managing advanced laryngeal cancer.
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