Upfront surgery vs radiotherapy for laryngeal cancer: descriptive study on the complications from rural cancer centre


  • Faiz Muqtadir Department of Head and Neck Oncology Kolhapur Cancer Center, Kolhapur, Maharashtra, India
  • Chaitanya Patil Pain and Palliative care, Kolhapur Cancer Center, Kolhapur, Maharashtra, India
  • Parag Watve Department of Head and Neck Oncology Kolhapur Cancer Center, Kolhapur, Maharashtra, India
  • Yogesh Anap Department of Radiation Oncology, Kolhapur Cancer Center, Kolhapur, Maharashtra, India
  • Priyal Patil Department of Head and Neck Oncology Kolhapur Cancer Center, Kolhapur, Maharashtra, India
  • Asha Soni Department of Head and Neck Oncology Kolhapur Cancer Center, Kolhapur, Maharashtra, India




Larygneal cancer, Radiotherapy, Surgery, Rural


Background: Significant shifts in therapy paradigms for advanced laryngeal carcinoma have occurred more recently. The number of patients receiving surgery alone has significantly decreased, while the number of patients receiving radiotherapy and chemoradiotherapy has significantly increased. Both the treatment modalities have its own advantages and disadvantages. The present study is a consideration to compare the complication rate of both the treatment modalities in the treatment of laryngeal cancer.

Methods: The head and neck oncosurgery department at the Kolhapur cancer center in Maharashtra conducted a five-year retrospective record analysis of the patients treated for carcinoma larynx [2017-2022]. The current analysis included all patients with histopathologically confirmed laryngeal cancer.

Results: Of the 24 cases if upfront surgery, 8 cases had complications and 8 cases of post RT, 6 cases had complications and this difference was statistically significant (p<0.05). There was significant difference between the pharynocutaneous fistula rates among the two groups. The rates were higher among post radiotherapy patients (p<0.05).

Conclusions: The most common complication among post radiotherapy was pharynocutaneous fistula. The most common complications among upfront surgery were pharynocutaneous fistula and stomal stenosis. Pharynocutaneous fistula was significantly higher among post radiotherapy patients when compared to upfront surgery.


Koroulakis A, Agarwal M. Laryngeal Cancer. In Treasure Island (FL). 2023.

Bobdey S, Jain A, Balasubramanium G. Epidemiological review of laryngeal cancer: An Indian perspective. Indian J Med Paediatr Oncol. 2015;36(3):154-60.

Nocini R, Molteni G, Mattiuzzi C, Lippi G. Updates on larynx cancer epidemiology. Chin J Cancer Res. 2020;32(1):18-25.

Zhang Q, Wang H, Zhao Q, Zhang Y, Zheng Z, Liu S, et al. Evaluation of Risk Factors for Laryngeal Squamous Cell Carcinoma: A Single-Center Retrospective Study. Front Oncol. 2021;11:606010.

Jurkiewicz D, Dzaman K, Rapiejko P. Laryngeal cancer risk factors. Pol Merkur Lekarski. 2006;21(121):94-8.

De Stefani E, Correa P, Oreggia F, Leiva J, Rivero S, Fernandez G, et al. Risk factors for laryngeal cancer. Cancer. 1987;60(12):3087-91.

Vassileiou A, Vlastarakos PV, Kandiloros D, Delicha E, Ferekidis E, Tzagaroulakis A, et al. Laryngeal cancer: smoking is not the only risk factor. B-ENT. 2012;8(4):273-8.

Shim YS. Recent advances in management of laryngeal cancer. Cancer Res Treat. 2004;36(1):13-8.

Sheahan P. Management of advanced laryngeal cancer. Rambam Maimonides Med J. 2014;5(2):e0015-e0015.

Do S Bin, Chung CH, Chang YJ, Kim BJ, Rho YS. Risk Factors of and Treatments for Pharyngocutaneous Fistula Occurring after Oropharynx and Hypopharynx Reconstruction. Arch Plast Surg. 2017;44(6):530-8.

Markou KD, Vlachtsis KC, Nikolaou AC, Petridis DG, Kouloulas AI, Daniilidis IC. Incidence and predisposing factors of pharyngocutaneous fistula formation after total laryngectomy. Is there a relationship with tumor recurrence? Eur Arch oto-rhino-laryngol. 2004;261(2):61-7.

Šifrer R, Aničin A, Pohar MP, Žargi M, Pukl P, Soklič T, et al. Pharyngocutaneous fistula: the incidence and the risk factors. Eur Arch oto-rhino-laryngol. 2016;273(10):3393-9.

Singh R, Karantanis W, Fadhil M, Dow C, Fuzi J, Robinson R, et al. Meta-analysis on the rate of pharyngocutaneous fistula in early oral feeding in laryngectomy patients. Am J Otolaryngol 2021;42(1):102748.

Chotipanich A, Wongmanee S. Incidence of Pharyngocutaneous Fistula After Total Laryngectomy and Its Relationship with the Shapes of Mucosa Closure: A Meta-Analysis. Cureus. 2022;14(9):e28822.

Busoni M, Deganello A, Gallo O. Pharyngocutaneous fistula following total laryngectomy: analysis of risk factors, prognosis and treatment modalities. Acta Otorhinolaryngol. 2015;35(6):400-5.

Mattioli F, Bettini M, Molteni G, Piccinini A, Valoriani F, Gabriele S, et al. Analysis of risk factors for pharyngocutaneous fistula after total laryngectomy with particular focus on nutritional status. Acta Otorhinolaryngol. 2015;35(4):243-8.

Leong SC, Kartha S-S, Kathan C, Sharp J, Mortimore S. Outcomes following total laryngectomy for squamous cell carcinoma: one centre experience. Eur Ann Otorhinolaryngol Head Neck Dis 2012;129(6):302-7.

Goepfert RP, Hutcheson KA, Lewin JS, Desai NG, Zafereo ME, Hessel AC, et al. Complications, hospital length of stay, and readmission after total laryngectomy. Cancer. 2017;123(10):1760-7.






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