{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T04:38:38Z","timestamp":1786941518024,"version":"build-2736575974"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T00:00:00Z","timestamp":1596844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate and compare the oncological and functional outcomes of total laryngectomies (TL) performed as first line treatment or for salvage after failure of conservative approaches for treating advanced laryngeal carcinoma (LSCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of 217 patients who underwent TL was divided according to whether the procedure was for primary treatment of their LSCC (101 patients) or for recurrences after conservative surgery or chemo\u2010radiotherapy (116 patients).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall survival rate and disease\u2010specific survival rate were significantly higher in the primary TL group than in the salvage TL group (<jats:italic>P<\/jats:italic> = .04 and <jats:italic>P<\/jats:italic> = .01, respectively). The recurrence rate was significantly higher and the disease\u2010free survival (in months) was shorter for patients who had salvage TL than for those who had primary TL (<jats:italic>P<\/jats:italic> = .00 and <jats:italic>P<\/jats:italic> = .01, respectively). The salvage TL group also included significantly more cases of postoperative pharyngo\u2010cutaneous fistula needing salivary stent positioning, and experienced significantly longer hospital stays than the primary TL group (<jats:italic>P<\/jats:italic> = .04 and <jats:italic>P<\/jats:italic> = .03, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Oncological and functional outcomes of primary TL were significantly better than after salvage TL. If salvage TL was performed after conservative surgery had failed, the oncological and functional results were better than after the failure of organ\u2010preserving protocols. This could justify a first attempt at conservative surgery for intermediate\u2010advanced LSCC in selected cases, reserving chemo\u2010radiotherapy only for patients unsuitable for surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:E569\u2013E575, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28955","type":"journal-article","created":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T15:24:48Z","timestamp":1596900288000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Oncological and Functional Outcomes of Primary and Salvage Total Laryngectomy"],"prefix":"10.1002","volume":"131","author":[{"given":"Andy","family":"Bertolin","sequence":"first","affiliation":[{"name":"Otolaryngology Unit, Vittorio Veneto Hospital  Treviso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2454-9618","authenticated-orcid":false,"given":"Marco","family":"Lionello","sequence":"additional","affiliation":[{"name":"Otolaryngology Unit, Vittorio Veneto Hospital  Treviso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Zanotti","sequence":"additional","affiliation":[{"name":"Department of Neuroscience DNS, Otolaryngology Section University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2306-4088","authenticated-orcid":false,"given":"Leonardo","family":"Franz","sequence":"additional","affiliation":[{"name":"Department of Neuroscience DNS, Otolaryngology Section University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano","family":"Giacomelli","sequence":"additional","affiliation":[{"name":"Department of Neuroscience DNS, Otolaryngology Section University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Rizzotto","sequence":"additional","affiliation":[{"name":"Otolaryngology Unit, Vittorio Veneto Hospital  Treviso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8751-0588","authenticated-orcid":false,"given":"Gino","family":"Marioni","sequence":"additional","affiliation":[{"name":"Department of Neuroscience DNS, Otolaryngology Section University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,8]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"210","article-title":"Total laryngectomy \u2010 past, present, future","volume":"9","author":"Cheachir O","year":"2014","journal-title":"Maedica J Clin Med"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-007-0456-0"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2018.11.022"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199803000-00006"},{"key":"e_1_2_6_6_1","first-page":"373","article-title":"Salvage total laryngectomy after conservation laryngeal surgery for recurrent laryngeal squamous cell carcinoma","volume":"36","author":"De Virgilio A","year":"2016","journal-title":"Acta Otorhinolaryngol Ital"},{"key":"e_1_2_6_7_1","first-page":"527","article-title":"Primary and salvage total laryngectomy. 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