{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T19:00:51Z","timestamp":1779217251105,"version":"3.51.4"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2018,1,2]],"date-time":"2018-01-02T00:00:00Z","timestamp":1514851200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>After radiation failure for early T\u2010stage larynx cancer, national guidelines recommend salvage surgery. Total laryngectomy and conservation laryngeal surgery with an open or endoscopic approach are both used. Beyond single\u2010institution studies, there is a lack of evidence concerning the outcomes of these procedures. We aim to study whether treatment with conservation laryngeal surgery is associated with poorer outcomes than treatment with total laryngectomy as salvage surgery after radiation failure for T1\/T2 larynx cancers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A retrospective study was conducted of adult squamous cell larynx cancer cases in the National Cancer Database diagnosed from 2004 to 2012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Commission on Cancer cancer programs in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Demographic, facility, tumor, and survival variables were included in the analyses. Multivariate survival regressions as well as univariate Kaplan\u2010Meier analyses were conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Slightly more than 7% of patients receiving radiotherapy for T1\/T2 larynx cancers later received salvage surgery. Salvage with partial laryngectomy was not associated with diminished survival as compared with total laryngectomy. However, positive surgical margins were associated with worse outcomes (hazard ratio, 1.782; <jats:italic>P<\/jats:italic> =. 001), and a larger percentage of patients receiving partial laryngectomy had positive margins than those receiving total laryngectomy. Facility characteristics were not associated with differences in salvage surgery type or outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In recognition of the inherent selection bias, patients who experienced recurrences after radiation for T1\/T2 larynx cancer and underwent conservation salvage laryngeal surgery demonstrated clinical outcomes similar to those of patients undergoing salvage total laryngectomy. Increased rates of positive surgical margins were observed among patients undergoing salvage conservation surgery.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817742596","type":"journal-article","created":{"date-parts":[[2018,1,4]],"date-time":"2018-01-04T14:56:31Z","timestamp":1515077791000},"page":"497-504","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Salvage Surgery after Radiation Failure in T1\/T2\u00a0Larynx Cancer: Outcomes following Total versus Conservation Surgery"],"prefix":"10.1002","volume":"158","author":[{"given":"Shayan","family":"Cheraghlou","sequence":"first","affiliation":[{"name":"Division of Otolaryngology Department of Surgery Yale School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phoebe","family":"Kuo","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Department of Surgery Yale School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saral","family":"Mehra","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Department of Surgery Yale School of Medicine New Haven Connecticut USA"},{"name":"Yale Cancer Center New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendell G.","family":"Yarbrough","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Department of Surgery Yale School of Medicine New Haven Connecticut USA"},{"name":"Yale Cancer Center New Haven Connecticut USA"},{"name":"Department of Pathology Yale School of Medicine New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin L.","family":"Judson","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Department of Surgery Yale School of Medicine New Haven Connecticut USA"},{"name":"Yale Cancer Center New Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,2]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Cancer Facts and Figures 2016","author":"American Cancer Society","year":"2016"},{"key":"e_1_2_8_3_1","unstructured":"Cancer Research UK.Laryngeal cancer: survival.http:\/\/www.cancerresearchuk.org\/about\u2010cancer\/laryngeal\u2010cancer\/survival. 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