Significance and indications of total laryngectomy in modern laryngeal oncology

Czech version

Authors: P. Urbánková ¹; B. Gál ¹; M. Slavik ²; M. Štrbová ¹; L. Urbánek ³
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku LF MU a FN u sv. Anny v Brně ¹; Klinika radiační onkologie, Masarykův onkologický ústav, Brno ²; I. chirurgická klinika LF MU a FN u sv. Anny v Brně ³
Published in: Otorinolaryngol Foniatr, 74, 2025, No. 2, pp. 117-122.
Category: Review Article
doi: https://doi.org/doi: 10.48095/ccorl2025117

Overview

Preserving a functional larynx and achieving long-term control is the basic postulate of treating patients with malignant tumors of the larynx, even in advanced stages. Therefore, non-surgical treatment protocols and larynx-preserving surgical procedures are preferred. Total laryngectomy is historically the basic procedure of laryngeal surgery still with the best survival outcomes in advanced laryngeal cancer, but with significantly lower quality of life following surgery. Nevertheless, there are still groups of patients who can benefit from this implementation. Local and overall characteristics are important for the recommendation of treatment. Tumor size, destruction and dysfunction of laryngeal structures, infiltration of the thyroid cartilage including the external perichondrium, or extralaryngeal extent are local factors when the expected effect of non-surgical treatment is insufficient or would only lead to the preservation of a non-functional larynx. We also recommend patients in whom organ-saving protocols are not suitable due to contraindications or there is a high risk of complications. Total laryngectomy still has its place as part of salvage surgery in failure of non-surgical treatment and for specific malignancies for which a non-surgical approach is not effective (most often sarcomas). We present our current view on the indications of total laryngectomy, which is based on international recommendations and our experience with multidisciplinary clinical decision-making.

Keywords:

total laryngectomy – advanced laryngeal cancer – organ-saving protocol

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