Postoperative radiotherapy reduces local and peristomal recurrence rates in laryngeal cancer patients with preoperative tracheotomyRadiotherapy May Lower Recurrence Risk After Laryngectomy for Cancer

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery Published July 25, 2026 Study authors: Uralov Daniel, Pace Gian Marco, Canali Luca, Teriaca Ausilia, Franzese Ciro, Mercante Giuseppe, Ferr… PubMed ↗ DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

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Key Takeaway

Consider postoperative radiotherapy to reduce local and peristomal recurrence rates in laryngeal cancer patients with preoperative tracheotomy.

This meta-analysis evaluates the impact of postoperative radiotherapy (PORT) on local and peristomal recurrence rates in 4339 patients undergoing primary total laryngectomy (TL). The analysis specifically examines outcomes in patients who underwent a preoperative tracheotomy, a condition associated with higher recurrence risks.

In patients without a preoperative tracheotomy, the local/peristomal recurrence rate was 7.0% (95% CI: 5.3-9.2). For those with a preoperative tracheotomy but no PORT, the recurrence rate was significantly higher at 34.8% (95% CI: 16.4-59.2). However, in patients with both a preoperative tracheotomy and PORT, the recurrence rate was reduced to 12.5% (95% CI: 7.8-19.5).

The data suggest that while preoperative tracheotomy is associated with increased recurrence rates, the addition of PORT may mitigate this risk. The study notes an association between these factors rather than a direct causal link. Clinical application should consider these findings as evidence for PORT in patients undergoing TL who have undergone a preceding tracheotomy.

This meta-analysis looked at 4,339 patients who underwent a total laryngectomy to treat laryngeal cancer. The study specifically focused on patients who had a tracheotomy (a tube in the neck) before their operation and how they responded to follow-up radiation therapy.

Researchers found that patients with a pre-existing tracheotomy were more likely to experience local or peristomal recurrence of cancer compared to those without one. However, for those who did have a tracheotomy, receiving postoperative radiotherapy (PORT) was associated with lower recurrence rates than not receiving it. Specifically, the recurrence rate was 12.5% with radiation versus 34.8% without it in that specific group.

Because this is a meta-analysis of proportions rather than a randomized trial, these results show an association rather than direct proof of cause. Patients should discuss how these findings might apply to their specific treatment plan and the risks of radiation with their oncology team.

What this means for you:

Radiotherapy may lower cancer recurrence rates for patients who had a tracheotomy before their laryngectomy surgery.

Common questions

Does radiation help after a laryngectomy?

For patients who had a tracheotomy before their surgery, postoperative radiotherapy was associated with lower rates of local cancer recurrence. In the study group, those receiving radiation had a 12.5% recurrence rate, while those who did not receive it had a much higher rate of 34.8%.

What is the risk of cancer returning after surgery?

The study found that patients with a preoperative tracheotomy had a higher local recurrence rate of 17.9% compared to those without one, who had a rate of 7.0%. These numbers help doctors understand how different factors might impact the likelihood of cancer returning.

Who is this finding for?

This information is most relevant for patients with laryngeal cancer undergoing a total laryngectomy, especially those who required a tracheotomy before their operation. You should talk to your doctor about how these findings relate to your specific medical history.

Study Details

Study typeMeta analysis

Sample sizen = 4,339

EvidenceLevel 1

PublishedJul 2026

PMID42080460

View Original Abstract ↓

OBJECTIVE: To evaluate the impact of postoperative radiotherapy (PORT) on local and peristomal recurrence in patients undergoing primary total laryngectomy (TL) with a preoperative tracheotomy. DATA SOURCES: A systematic search of PubMed, Scopus, and Google Scholar was conducted. REVIEW METHODS: A single-arm meta-analysis of proportions was performed to estimate pooled local/peristomal recurrence rates. The inverse variance method was used to calculate effect sizes and 95% confidence intervals (CIs). RESULTS: A total of 4339 patients undergoing primary TL without preoperative radiation therapy were included. Preoperative tracheotomy was performed in 879/4339 (20.3%) cases. The pooled local/peristomal recurrence rate was 7.0% (95% CI: 5.3-9.2) in patients without preoperative tracheotomy and 17.9% (95% CI: 12.8-24.6) in those with tracheotomy. Among patients with preoperative tracheotomy, those who received PORT had a lower recurrence rate of 12.5% (95% CI: 7.8-19.5) compared to 34.8% (95% CI: 16.4-59.2) in those who did not receive PORT. CONCLUSIONS: Preoperative tracheotomy is associated with a markedly increased risk of local/peristomal recurrence following primary TL. Our findings suggest that PORT may reduce this risk and can be considered in patients undergoing TL with a preoperative tracheotomy.

Postoperative radiotherapy reduces local and peristomal recurrence rates in laryngeal cancer patients with preoperative tracheotomyRadiotherapy May Lower Recurrence Risk After Laryngectomy for Cancer

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