• advanced laryngeal cancer
• laryngeal cancer
• laryngeal function preservation
• OPHL
• Organ preservation

Laryngeal cancer is a relevant clinical problem, in fact despite all the advances in laryngeal oncology, survival rate for advanced stages (III-IV) remains<50%. The organ preservation strategy, surgical (OPHL) and non surgical (CRT), demonstrated that larynx preservation is feasible. The aim of this study was to assess the efficacy of OPHL +/- adjuvant (adj) therapy for advanced stage of laryngeal cancer, evaluating the laryngeal function and survival of the patients (pts) and comparing the outcomes with similar reported in literature. We analyzed a retrospective cohort of pts treated with OPHL (with or without Neck Dissection and adj therapy) at the Department of Otolaryngology & Head and Neck Surgery of the European Institute of Oncology. 110 cases were included. The 5-year Overall Survival, Disease Specific Survival, Disease Free Survival, Laryngeal Free Survival and Laryngeal Function Preservation Free Survival were 67%, 81%, 57%, 65%, and 66%, respectively. The local, regional and loco-regional control rate were: 96.4%, 95.4% and 90%. The great part of our pts (95.5%) maintained a functional larynx in place and pts underwent OPHL plus adj therapy achieved better oncological outcomes compared with pts that received CRT in literature. We could say that an adequate recruitment of patients and their tumors extension, could permit a proper conservative surgical treatment also for pT3 and selected pT4a advanced laryngeal cancers with good functional and oncological results.