16528 Background: With the advent of chemoradiation the role of surgery in management of cancer of larynx and hypopharynx has come down considerably. Aim: To evaluate the overall outcome of surgery for carcinoma of the larynx and hypopharynx, with a view to establish its role in management of cancer of larynx and hypopharynx. Patients and Methods: All patients who have undergone laryngectomy at the Division of Surgical Oncology RCC from June 1995 to Dec 2005 were included in the study which retrospectively recorded the age and sex distribution TNM staging, the indications and types of laryngectomy, and reconstructive options used. The influence of preoperative chemotherapy, radiotherapy, and tracheostomy, systemic illness like diabetes melletus and COPD on the surgical outcome was assessed. Results: The ages of the patient ranged from 23 years to 75 years with a mean ± s.d of 55 ± 9.5 years. Out of a total of 167 cases, 123 (74%) cases had salvage surgery for failed chemo RT/Radical RT and 44 (26%) had primary surgical treatment. Conservation surgery was undertaken in 4 cases, Near total laryngectomy/laryngopharyngectomy (NTL/NTLP) was done in 14, Total laryngopharyngo esophagectomy (TLPE) with gastric pull up was done in 5 and total laryngectomy (TL) or TL with partial or subtotal pharyngectomy was done in 142 cases. 62 (37 %) patients had postoperative leaks, 5 leaks persisted to form pharyngocutaneous fistulae. 2 were repaired and in 2 cases speech prosthesis insertion was possible due its anatomical position. 1 patient refused further surgical closure after a previously failed repair. Fifty-six (34%) patients recurred locoregionally. Four (2.3%) patients developed second primary and 5 (2.9%) had distant metastasis. Wound infection, previous radiation and diabetes melletes were the predominant predisposing factors for the leaks and wound related complications were the commonest cause for prolongation of postoperative hospital stay. Seventy-nine patients were alive at the time of study. Conclusions: Hypopharyngeal cancers warrant a closer follow up after an organ preservation protocol, to detect recurrence at the earliest and plan for an effective salvage surgery. No significant financial relationships to disclose.
Role of micronucleus in oral exfoliative cytology