Prognostic indicators and survival in salvage surgery for laryngeal cancer

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.