Prognostic indicators and survival in salvage surgery for laryngeal cancer

Kyle T. Fletcher, Thomas J. Gal, Andrew J. Ebelhar, Joseph Valentino, Yolanda M. Brill, Emily V. Dressler, Rony K. Aouad

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Background: Perineural invasion (PNI) and lymphovascular invasion (LVI) are known to be poor prognostic indicators in primary surgery. The purpose of this study was to determine their impact on survival in the setting of salvage laryngectomy. Methods: We conducted a retrospective review of patients who underwent salvage laryngectomy between 2006 and 2014. Results: Seventy-eight patients were included in this study; PNI was diagnosed in 48 patients (61.54%) and LVI in 25 patients (32.05%). Median overall survival was 32 months; PNI was associated with decreased survival; and the unadjusted hazard ratio (HR) was 2.69 (P =.006). Cases of LVI trended toward a decreased survival; with an unadjusted HR of 1.74 (P =.076). On multivariate analysis, PNI, LVI, or both conferred decreased survival compared to having neither (P =.01). Extracapsular spread and nodal metastases significantly impacted survival, and positive margins trended toward significance. Conclusion: The presence of PNI, LVI, nodal disease, and extracapsular spread significantly affected survival in this cohort of patients with laryngeal cancer.

Original languageEnglish
Pages (from-to)2021-2026
Number of pages6
JournalHead and Neck
Issue number10
StatePublished - Oct 2017

Bibliographical note

Publisher Copyright:
© 2017 Wiley Periodicals, Inc.


  • cancer
  • larynx
  • perineural invasion
  • salvage
  • survival

ASJC Scopus subject areas

  • Otorhinolaryngology


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