The Role of the Free/Pedunculated Flap in Total Laryngectomy After (Chemo-)Radiotherapy Failure for Laryngeal Carcinoma: Impact on the Risk of Pharyngocutaneous Fistula (PCF)
Multicenter, prospective, randomized study aimed at evaluating the difference in risk of PCF after salvage laryngectomy in two groups of patients: one cohort treated with Total Laryngectomy (LT) with primary suture, a second group treated with LT and reinforcement by flap positioning with onlay technique (PMM, ALT)
- EligibilityCriteria: Inclusion Criteria:  Histological confirmation of recurrence/persistence of squamous cell carcinoma of the larynx previously subjected to exclusive radiotherapy or concomitant chemo-radiotherapy treatment:  pre (ChT-)RT staging: cT1/T2/T3 N0/N+; pre STL staging: rcT1/cT2/ Selected cT3 cT4a (extension to thyroid cartilage and/or prelaryngeal tissues) N0/N+ (clinically and radiologically). Indication for STL surgery (no pharyngeal mucosal resection); Functional total laryngectomies after radical (chemo-)radiotherapy treatment; Age > 18 years; Signature of informed consent and ability to complete in-office questionnaires.  Exclusion Criteria:  STL extended to the pharynx and/or total pharyngeal laryngectomies; Extension of the tumor to the pharyngeal mucosa and/or massive extra-laryngeal extension; Previous open organ preservation surgery (OPHL). - Gender: All - MinimumAge: 18 Years - StdAgeList: Adult, Older Adult - StudyPopulation: Patients suffering from recurrence/persistence of laryngeal SCC following exclusive RT treatment or concomitant RT/ChT without extension to the pharynx (rcT1/T2/T3 selected rcT4a N0/N+) who will have to undergo STL and who will meet the following criteria. Patients undergoing extensive laryngectomies or with disease with even partial involvement of the pharyngeal mucosa (pyriform sinus, posterior wall of the pharynx) will not be included. - SamplingMethod: Non-Probability Sample