Total Laryngectomy for Laryngeal Cancer in a NigerianTertiary Health Center: Prognosis and Outcome

Background: advanced laryngeal cancers presenting withupper airway obstruction are a common scenario in sub-saharan africa, requiring operative intervention as a priority.objective: to assess outcome of total laryngectomy as atreatment option in the surgical management of advancedlaryngeal cancers in a tertiary health institution in northwesternnigeria. materials and methods: a retrospective analysis oftotal laryngectomies for laryngeal cancers carried out by onesurgeon from december 2000 to august 2009. results: outof 30 patients with histologically diagnosed laryngeal cancer,18 were treated with total laryngectomy fourteen (77.8%)were males, while 4 (22.2%) were females, with a male-tofemaleratio of 3.5:1. the age range was 20-70 years with amean age of 47years for males and 33.8 years for females.total laryngectomy was carried out on t4 lesions (100%),with preoperative tracheostomy (100%) carried out as anemergency measure to relieve upper airway obstruction. twofemale patients had safe vaginal deliveries after their surgeries.although all patients were referred for radiotherapy, only 6(33.3%) patients could afford postoperative radiotherapy, witha 5-year survival rate of 33.3%; while all others could not affordthe cost of radiotherapy treatment, which was to be carried outat a center about 5 hours drive away from our center. seven(38.9%) patients presented with recurrent neck nodal disease,while 3 (16.7%) had carotid blow-out hemorrhage that wasfatal. conclusion: total laryngectomy remains an importantsurgical modality of treatment for advanced laryngeal cancers,as it affords the patient an opportunity of longer survival whencombined with postoperative radiotherapy. it is superior to‘radiotherapy only’ or ‘surgery only’ or nothing.