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Ahmadi A, Sanaei A, Abedin F, Salem MM. Evaluating of Supraglottic Subunits in Swallowing Function in Supraglottic Cancer Patients Pre- and Post-Transoral Laser Microsurgery. Indian J Otolaryngol Head Neck Surg 2024; 76:4448-4454. [PMID: 39376452 PMCID: PMC11455744 DOI: 10.1007/s12070-024-04884-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/04/2024] [Indexed: 10/09/2024] Open
Abstract
BACKGROUND AND AIM This study aims to assess the impact of supraglottic cancer on swallowing functionality and its anatomical correlations before and after laser surgery. The study seeks to determine the extent of score changes post-surgery, pinpoint the most influential anatomical component in swallowing, predict post-surgery outcomes, and ascertain the effect on patients' quality of life. METHODS Patients with supraglottic cancer and dysphagia were identified through stroboscopy and indirect laryngoscopy. Exclusion criteria encompassed a history of prior radiotherapy, chemotherapy, or distant metastases. Demographic data, tumor stage, comorbidities, risk factors, and treatment details were documented. Swallowing evaluation employed the translated EAT10 self-assessment questionnaire, administered before and after transoral laser microsurgery (TLM) at baseline and 6 months later. Additional treatments, rehabilitation duration, NG tube use, and post-surgery complications were recorded. RESULTS At the six-month follow-up, 9 patients had EAT-10 scores ≥ 3, while 7 patients scored < 3. Five patients underwent post-TLM additional therapies, and 9 patients had neck dissections. Involved subunits were epiglottis (11 patients), arytenoid (5 patients), FVC (13 patients), and TVC (3 patients). Seven patients received dysphagia treatment. Analysis revealed significant associations between follow-up EAT-10 scores and dysphagia treatment (p = 0.04), smoking (p = 0.02), and FVC involvement (p = 0.02). CONCLUSION Our study on supraglottic cancer treatment with transoral laser microsurgery (TLM) revealed variable EAT-10 scores after a six-month follow-up. Adjunctive therapies and neck dissections were administered to some patients. Significant associations were found between follow-up scores, dysphagia treatment, smoking history, and FVC involvement, highlighting the complex interplay between interventions and patient factors. Further research is needed for optimization.
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Affiliation(s)
- Aslan Ahmadi
- ENT and Head &Neck Research center, The Five senses Institute, Iran University of Medical Sciences, Tehran, 1445613131 Iran
| | - Ayda Sanaei
- ENT and Head &Neck Research center, The Five senses Institute, Iran University of Medical Sciences, Tehran, 1445613131 Iran
| | - Fatemeh Abedin
- ENT and Head &Neck Research center, The Five senses Institute, Iran University of Medical Sciences, Tehran, 1445613131 Iran
| | - Mohammad Mahdi Salem
- ENT and Head &Neck Research center, The Five senses Institute, Iran University of Medical Sciences, Tehran, 1445613131 Iran
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Zorzi S, Pietrobon G, Mossinelli C, Bandi F, Chu F, Tagliabue M, De Berardinis R, Zocchi J, Alterio D, Rocca MC, Ruju F, Ansarin M. Outcomes of mini-invasive transoral surgery without neck dissection in supraglottic laryngeal cancer: Real world data from a tertiary cancer center. Am J Otolaryngol 2024; 45:104113. [PMID: 37956498 DOI: 10.1016/j.amjoto.2023.104113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE The neck management in early-stage cN0 supraglottic cancer represents an argument of debate. The aim of our study is to evaluate the oncological and functional outcomes in patients with early-stage cN0 supraglottic carcinoma treated with a wait-and-see policy for the neck. MATERIALS AND METHODS Retrospective monocentric cohort study in a referral cancer care center. We collected a consecutive sample of patients from 2000 to 2020 with Squamous Cell Carcinoma of the supraglottis without clinical evidence of nodal metastases (cN0), surgically treated with Transoral Surgery (Laser or Robotic) without neck dissection. From 316 supraglottic cancer we finally selected 66 eligible participants that met all inclusion criteria. RESULTS Sixty-six patients (M 75.8 % vs F 24.2 %), median age 65.8 years (IQR 60.9, 70.5). The most common subsite was the epiglottis (62.1 %). Tumor stage distribution was as follows: 35 % cT1, 53 % cT2, 15.2 % cT3. Neither deaths nor major treatment-related complications were reported after surgery. The median follow-up was 62 months. For oncological outcomes, we evaluated 56 patients (10 excluded for adjuvant radiotherapy): 5-year overall survival rate 87 % (CI 95 %: 73.1-94), disease- specific survival rate 95.3 % (CI 95 %: 82-98.8) and neck recurrence-free survival rate 87 % (CI 95 %: 73.1-94). Six patients developed neck recurrence, with a median time of 13 months. CONCLUSIONS Supraglottic carcinoma has been historically associated to a considerable risk of occult metastasis. However, in early-stage cases data are still inconclusive. Our results suggest that in such patients a wait-and-see policy does not impact negatively on survival outcomes, while granting the reduced morbidity associated to a minimally invasive surgical approach.
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Affiliation(s)
- Stefano Zorzi
- Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Giacomo Pietrobon
- Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Chiara Mossinelli
- Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
| | - Francesco Bandi
- Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Francesco Chu
- Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Marta Tagliabue
- Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy; Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Rita De Berardinis
- Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Jacopo Zocchi
- Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Daniela Alterio
- Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Maria Cossu Rocca
- Division of Medical Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Francesca Ruju
- Division of Radiology, IEO, European Institute of Oncology, IRCCS, Milan, Italy
| | - Mohssen Ansarin
- Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy
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3
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Abstract
Although total laryngectomy continues to be important treatment of supraglottic laryngeal cancer, the management of early-stage disease has evolved from primary radiation/chemoradiation to consideration of partial laryngectomy surgery. Surgeon experience and careful patient selection can lead to excellent oncologic and functional outcomes for these techniques. However, advanced stage tumors and salvage situations are challenging and the ability to eradicate disease and preserve function should be carefully considered. Contraindications to supraglottic laryngectomy depend on surgical approach, as do complications. With adequate patient selection, high rates of cure and function can be achieved with both open and transoral supraglottic laryngectomy procedures.
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Affiliation(s)
- Rusha Patel
- Oklahoma University, 800 Stanton L Young Boulevard, Suite 1400, Oklahoma City, OK 73104, USA.
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4
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Friedrich RE, Quade M, Jowett N, Kroetz P, Amling M, Kohlrusch FK, Zustin J, Gosau M, SchlÜter H, Miller RJD. Ablation Precision and Thermal Effects of a Picosecond Infrared Laser (PIRL) on Roots of Human Teeth: A Pilot Study Ex Vivo. In Vivo 2021; 34:2325-2336. [PMID: 32871757 DOI: 10.21873/invivo.12045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND/AIM Picosecond infrared laser (PIRL) was investigated regarding its possible therapeutic application in cutting dental roots. MATERIALS AND METHODS Extracted human teeth were processed in the root area by laser ablations followed by histological evaluation. Dentin adjacent to the cutting surface was evaluated morphometrically. RESULTS PIRL produced clearly defined cutting boundaries in dental roots. At the bottom of the cavity, the ablation surface became slightly concave. Heat development in this scantly hydrated tissue was considerable. We attributed the excess heating effects to heat accumulation due to multiple pulse overlap across a limited scan range imposed by tooth geometries. CONCLUSION Defined areas of the tooth root may be treated using the PIRL. For clinical translation, it would be necessary to improve beam delivery to facilitate beam steering for the intended oral application (e.g. by using a fiber) and identify optimal repetition rates/scan speeds combined with cooling techniques to minimize accumulated heat within ablation cavities.
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Affiliation(s)
- Reinhard E Friedrich
- Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Maria Quade
- Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Nate Jowett
- Otorhinolaryngology, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany.,Otolaryngology - Head and Neck Surgery, Mass Eye & Ear and Harvard Medical School, Boston, MA, U.S.A.,Atomically Resolved Dynamics Division, Max Planck Research Department for Structural Dynamics, University of Hamburg, Hamburg, Germany
| | - Peter Kroetz
- Atomically Resolved Dynamics Division, Max Planck Research Department for Structural Dynamics, University of Hamburg, Hamburg, Germany
| | - Michael Amling
- Institute of Osteology and Biomechanics, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Felix K Kohlrusch
- Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Jozef Zustin
- Institute of Osteology and Biomechanics, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany.,Institute of Pathology, Gemeinschaftspraxis Pathologie-Regensburg, Regensburg, Germany
| | - Martin Gosau
- Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - Hartmut SchlÜter
- Institute of Clinical Chemistry and Laboratory Medicine, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
| | - R J Dwayne Miller
- Atomically Resolved Dynamics Division, Max Planck Research Department for Structural Dynamics, University of Hamburg, Hamburg, Germany.,Departments of Chemistry and Physics, University of Toronto, Toronto, Canada.,PIRL Laboratory, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
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5
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Dyckhoff G, Warta R, Herold-Mende C, Rudolph E, Plinkert PK, Ramroth H. An Observational Cohort Study on 194 Supraglottic Cancer Patients: Implications for Laser Surgery and Adjuvant Treatment. Cancers (Basel) 2021; 13:568. [PMID: 33540592 PMCID: PMC7867201 DOI: 10.3390/cancers13030568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 01/14/2023] Open
Abstract
Supraglottic laryngeal cancer is characterized by poor prognosis. In contrast, excellent outcomes have been published in early-stage supraglottic cancers after laser surgery in single-institutional series in centers of excellence. Are these results reproducible in the normal clinical practice of less specialized facilities? As part of an observational cohort study, the outcomes of 194 supraglottic cancer patients were assessed after treatment by larynx-preserving surgery (transoral laser microsurgery [TLM] or open partial laryngectomy [OPL]) or total laryngectomy (TL), with each having risk-adopted adjuvant treatment, or primary (chemo-)radiotherapy (pCRT or pRT). In early-stage supraglottic cancers, TLM achieved a 5-year overall survival (5-year OS) of 62.0%. No significant survival difference could be discerned between patients with and without adjuvant treatment (HR 1.47; 95% CI: 0.80 2.69). The comparison between pCRT and pRT patients suggests that CRT is more effective in supraglottic cancer. The 5-year OS rate achieved in our multiinstitutional setting is comparable to that reached in laser surgery centers of excellence (59.4-76.0%). According to our data and supported by the literature, adjuvant RT (aRT) is not sufficiently effective in supraglottic cancers. In case adjuvant therapy is indicated, adjuvant chemoradiation (aCRT) could be recommended.
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Affiliation(s)
- Gerhard Dyckhoff
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, 69120 Heidelberg, Germany; (C.H.-M.); (R.W.); (P.K.P.)
| | - Rolf Warta
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, 69120 Heidelberg, Germany; (C.H.-M.); (R.W.); (P.K.P.)
| | - Christel Herold-Mende
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, 69120 Heidelberg, Germany; (C.H.-M.); (R.W.); (P.K.P.)
| | - Elisabeth Rudolph
- Heidelberg Institute of Global Health, University of Heidelberg, 69120 Heidelberg, Germany; (E.R.); (H.R.)
| | - Peter K. Plinkert
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Heidelberg, 69120 Heidelberg, Germany; (C.H.-M.); (R.W.); (P.K.P.)
| | - Heribert Ramroth
- Heidelberg Institute of Global Health, University of Heidelberg, 69120 Heidelberg, Germany; (E.R.); (H.R.)
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6
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Litvinova K, Chernysheva M, Stegemann B, Leyva F. Autofluorescence guided welding of heart tissue by laser pulse bursts at 1550 nm. BIOMEDICAL OPTICS EXPRESS 2020; 11:6271-6280. [PMID: 33282489 PMCID: PMC7687929 DOI: 10.1364/boe.400504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/30/2020] [Accepted: 10/06/2020] [Indexed: 06/12/2023]
Abstract
Wound healing and other surgical technologies traditionally solved by suturing and stapling have recently been enhanced by the application of laser tissue welding. The usage of high energy laser radiation to anastomose tissues eliminates a foreign body reaction, reduces scar formation, and allows for the creation of watertight closure. In the current work, we show that an ultrafast pulsed fibre laser beam with 183 µJ·cm-2 energy fluence at 1550 nm provides successful welding of dissected chicken heart walls with the tensile strength of 1.03±0.12 kg·cm-2 equal to that of native tissue. The welding process was monitored employing fluorescence spectroscopy that detects the biochemical composition of tissues. We believe that fluorescence spectroscopy guided laser tissue welding is a promising approach for decreasing wound healing times and the avoiding risks of postoperative complications.
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Affiliation(s)
- Karina Litvinova
- Aston Medical School, Aston University, Aston Triangle, B4 7ET, Birmingham, UK
| | - Maria Chernysheva
- Leibniz Institute of Photonic Technology, Albert Einstein str 9, 07745, Jena, Germany
| | - Berthold Stegemann
- Aston Medical School, Aston University, Aston Triangle, B4 7ET, Birmingham, UK
| | - Francisco Leyva
- Aston Medical School, Aston University, Aston Triangle, B4 7ET, Birmingham, UK
- Cardiology Department, Queen Elizabeth Hospital, Mindelsohn Way, B15 2TH, Birmingham, UK
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7
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Gupta K, Dabas S, Ranjan R, Sharma A, Shukla H. Oncological outcome following TORS in HPV negative supraglottic carcinoma. Indian J Cancer 2019; 56:9-14. [DOI: 10.4103/ijc.ijc_172_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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8
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van der Woerd B, Patel KB, Nichols AC, Fung K, Yoo J, MacNeil SD. Functional outcomes in early (T1/T2) supraglottic cancer: a systematic review. J Otolaryngol Head Neck Surg 2018; 47:76. [PMID: 30563567 PMCID: PMC6299571 DOI: 10.1186/s40463-018-0321-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 11/22/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Organ preserving surgery (OPS) and radiotherapy (RT) are both accepted treatment options for early stage supraglottic cancer (SGC). Radiation has supplanted surgery in most cases, because of the perception that surgery results in poorer functional outcomes. However, evidence suggests that OPS with a neck dissection may be associated with improved survival. Our objective was to conduct a systematic review of the literature to compare functional outcomes of OPS and RT for early SGC. METHODS We searched Medline, EMBASE and Cochrane Central Register of Controlled Trials to identify studies. Studies were included if they reported functional outcomes on 10 or more patients with early stage SGC treated with radiation or OPS, including open partial laryngectomy, transoral laser microsurgery (TLM) or transoral robotic surgery (TORS). Two reviewers independently screened articles for relevance using pre-determined criteria. RESULTS From 7720 references, we included 10 articles (n = 640 patients). 50% (n = 320) of patients were treated with surgery. Three head-to-head RT versus OPS papers were included, however different outcome measures were used for each group. Intractable aspiration management (including total laryngectomy or permanent tracheostomy) following OPS was reported in five papers representing 186 patients; the definitive intractable aspiration management rate was 2.6% (95% CI 1.0-6.8%). Four papers reported permanent G-tube rate for the surgical group (n = 198), calculating a rate of 5.3% (95% CI 2.6-10.5%), this was not reported for the RT group in any papers. One study reported quality of life. Two studies reported objective voice measures. CONCLUSIONS This systematic review revealed a paucity of objective measures and significant data heterogeneity, rendering the comparison of functional outcomes following OPS versus RT for early SGC limited. Future research should include objective measures of functional outcomes including laryngectomy rate, g-tube rate, tracheostomy dependence, quality of life, and voice quality measures.
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Affiliation(s)
- Benjamin van der Woerd
- Department of Otolaryngology, Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada
| | - Krupal B Patel
- Department of Otolaryngology, Head and Neck Surgery, The Ohio State University, Columbus, OH, USA
| | - Anthony C Nichols
- Department of Otolaryngology, Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada
| | - Kevin Fung
- Department of Otolaryngology, Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada
| | - John Yoo
- Department of Otolaryngology, Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada
| | - S Danielle MacNeil
- Department of Otolaryngology, Head & Neck Surgery, Schulich Medicine & Dentistry, Western University, London Health Sciences Centre, Victoria Hospital, London, Ontario, Canada.
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9
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Odenthal J, Friedl P, Takes RP. Compatibility of CO 2 laser surgery and fluorescence detection in head and neck cancer cells. Head Neck 2018; 41:1253-1259. [PMID: 30549379 DOI: 10.1002/hed.25547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 10/08/2018] [Accepted: 10/29/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Surgical treatment of cancer requires tumor excision with emphasis on function preservation which is achieved in (early stage) laryngeal cancer by transoral carbon dioxide (CO2 ) laser surgery. Whereas conventional laser surgery is restricted by the surgeon's visual recognition of tumor tissue, new approaches based on fluorescence-guided surgery (FGS) improve the detection of the tumor and its margin. However, it is unclear whether fluorophores are compatible with high-power laser application or whether precision is compromised by laser-induced bleaching of the dye. METHODS We applied topology-controlled 3D laser resection of fluorescent tumors cell in vitro and laser-induced autofluorescence analysis ex vivo. RESULTS Laser-induced bleaching of fluorescent dyes in the visible and near-infrared light spectrum (650-900 nm) ranges below the resolution range of operation microscopes. Furthermore, specific fluorescent signals in an FGS mouse model is 104 higher than laser-induced autofluorescence in mouse tissue. CONCLUSION Laser-induced lateral photobleaching is negligible indicating a path forward for fluorescence-guided laser surgery in head and neck cancer.
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Affiliation(s)
- Julia Odenthal
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Cell Biology, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Peter Friedl
- Department of Cell Biology, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands.,Genitourinary Medical Oncology - Research, UT MD Anderson Cancer Center, Houston, Texas.,Cancer Genomics Center, Utrecht, The Netherlands
| | - Robert P Takes
- Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
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10
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Patel TD, Echanique KA, Yip C, Hsueh WD, Baredes S, Park RCW, Eloy JA. Supraglottic Squamous Cell Carcinoma: A Population-Based Study of 22,675 Cases. Laryngoscope 2018; 129:1822-1827. [PMID: 30536822 DOI: 10.1002/lary.27592] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS The authors used the Surveillance, Epidemiology, and End Results (SEER) database to analyze epidemiological features of patients presenting with supraglottic squamous cell carcinoma (SCCa) and to evaluate treatment trends and outcomes. METHODS The SEER database was queried for patients with supraglottic SCCa from 1973 to 2013. Information on demographics; tumor size; histologic grade; American Joint Committee on Cancer (AJCC) stage; SEER local, regional, distant stage; and treatment modality were analyzed. RESULTS There were 22,675 cases of primary supraglottic SCCa identified. The mean age at diagnosis was 62.3 years, with males accounting for 70.3% of all cases. A high percentage of patients presented with stage IV disease (44.9%). The most common treatment modality was radiotherapy (46.6%), followed by combination of surgery and radiotherapy (29.2%) and surgery alone (15.0%). Overall 5-year disease-specific survival (DSS) for all cases was 54.0%. When stratified by treatment modality, 5-year DSS was best for patients receiving surgery alone (64.2%). However, for patients with AJCC stage IV disease, survival was significantly better with combined surgery and radiotherapy (52.5%). CONCLUSION In general, supraglottic SCCa is treated most commonly with radiotherapy, followed by surgery and radiotherapy. Patients managed surgically had better 5-year DSS when compared to patients treated by other modalities. However, when stratified by stage, patients with AJCC stage IV disease had significantly better survival with combined surgery and radiotherapy. Of patients receiving surgery, supraglottic laryngectomy was found to have a significantly better 5-year DSS when compared to both total laryngectomy and laryngectomy, not otherwise specified. LEVEL OF EVIDENCE NA Laryngoscope, 129:1822-1827, 2019.
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Affiliation(s)
- Tapan D Patel
- Department of Otolaryngology-Head and Neck Surgery, Neurological Institute of New Jersey, Newark, New Jersey, U.S.A
| | - Kristen A Echanique
- Department of Otolaryngology-Head and Neck Surgery, Neurological Institute of New Jersey, Newark, New Jersey, U.S.A
| | - Candice Yip
- Department of Otolaryngology-Head and Neck Surgery, Neurological Institute of New Jersey, Newark, New Jersey, U.S.A
| | - Wayne D Hsueh
- Department of Otolaryngology-Head and Neck Surgery, Neurological Institute of New Jersey, Newark, New Jersey, U.S.A
| | - Soly Baredes
- Department of Otolaryngology-Head and Neck Surgery, Neurological Institute of New Jersey, Newark, New Jersey, U.S.A.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Newark, New Jersey, U.S.A
| | - Richard Chan Woo Park
- Department of Otolaryngology-Head and Neck Surgery, Neurological Institute of New Jersey, Newark, New Jersey, U.S.A
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Neurological Institute of New Jersey, Newark, New Jersey, U.S.A.,Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Newark, New Jersey, U.S.A.,Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A.,Department of Ophthalmology and Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey, U.S.A
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11
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Carta F, Mariani C, Sambiagio GB, Chuchueva N, Lecis E, Gerosa C, Puxeddu R. CO 2 Transoral Microsurgery for Supraglottic Squamous Cell Carcinoma. Front Oncol 2018; 8:321. [PMID: 30234007 PMCID: PMC6131582 DOI: 10.3389/fonc.2018.00321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 07/27/2018] [Indexed: 02/05/2023] Open
Abstract
The present study analyzed the results of the endoscopic approach to T1, T2 and selected T3 supraglottic carcinoma with the aim of reviewing functional and oncologic outcomes after different types of endoscopic supraglottic laryngectomies. This is a retrospective clinical study of 42 consecutive patients (mean age of 61.8 years, 33 males, 9 females) treated by the senior author for supraglottic squamous cell carcinoma with a transoral CO2 laser approach and reviewed from November 2010 to September 2017. Surgical procedures were classified according to the European Laryngological Society. In addition to the standardized transoral supraglottic laryngectomies, we introduced a modified type IVb by sparing the inferior third of the arytenoid if not directly involved in the tumor. Swallowing was evaluated with the Swallowing Performance Status Scale reported by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. Survival probabilities were estimated using Kaplan-Meier curves. Two type I, 2 type IIa, 2 type IIb, 3 type IIIa, 12 type IIIb, 13 type IVa, 3 type modified IVb, and 5 type IVb supraglottic laryngectomies were performed. Twenty-one patients (50%) underwent primary neck dissection. The pathologic TNM classification according to the 8th edition of the American Joint Committee on Cancer system was as follows: 9 pT1cN0, 2 pT1N0, 1 pT1N1, 7 pT2cN0, 1 rypT2cN0, 9 pT2N0, 4 pT2N1, 2 ypT2N1, 2 pT3cN0, 2 rypT3cN0, 1 pT3N1, and 2 pT3N2b. Mean follow-up was 3.4 years (range of 9 months to 6 years). According to the Kaplan-Meier analysis, 5-year disease-specific survival, local-relapse-free survival, nodal-relapse-free survival, overall laryngeal preservation and overall survival of patients without previous head and neck radiotherapy/open surgery were 100%, 95.2%, 87.8%, 100%, and 64.6%, respectively. Patients who underwent type I, IIa, and IIb resections (n = 6) started oral feeding the day after surgery, patients who underwent type III-IVb modified resections (n = 31) started oral feeding 3-4 days after surgery, and patients who underwent standard type 4b resections (n = 5) started oral feeding 7 days after surgery. Three months after surgery, patients without a clinical history of previous head and neck radiotherapy/open surgery who underwent type III, IVa, and modified IVb resections showed significantly better swallowing compared to patients who underwent standard type IVb resection: grade 4-6 impairment of swallowing in 8 and 66.7% of cases, respectively (p = 0.006072); patients with a clinical history of previous head and neck radiotherapy/open surgery who underwent type III, IVa, and modified IVb resections showed not statistically significant better swallowing compared to patients who underwent standard type IVb resection: grade 4-6 impairment of swallowing at 3 months in 16.7% and 50% of cases, respectively (p = 0.23568). Transoral CO2 laser supraglottic laryngectomy is an oncologic sound alternative to traditional open neck surgery and chemo-radiotherapy. Recovery of swallowing is significantly worsened after total resection of the arytenoid. Modified type IVb procedure leaving intact, when possible, the inferior third of the arytenoid and consequently the glottic competence, improves functional outcome.
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Affiliation(s)
- Filippo Carta
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Cinzia Mariani
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | | | | | - Elisa Lecis
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Clara Gerosa
- Unit of Pathology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
| | - Roberto Puxeddu
- Unit of Otorhinolaryngology, Department of Surgery, Azienda Ospedaliero-Universitaria di Cagliari, University of Cagliari, Cagliari, Italy
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Gorphe P. A Contemporary Review of Evidence for Transoral Robotic Surgery in Laryngeal Cancer. Front Oncol 2018; 8:121. [PMID: 29721446 PMCID: PMC5915483 DOI: 10.3389/fonc.2018.00121] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/04/2018] [Indexed: 12/03/2022] Open
Abstract
Numerous studies have shown that transoral robotic surgery (TORS) for oropharyngeal cancers is safe and that it yields satisfactory functional and oncological outcomes. For many teams worldwide, it is therefore a standard surgical approach with eligible patients. In the same time, TORS is increasingly being used and described in the context of laryngeal cancer surgery. It is proposed as an alternative to open approaches, which may yield inconsistent functional results and significant rates of postoperative complications. It may also be an alternative to definitive radiotherapy, which entails significant early and late toxicities. Moreover, it has been explored as an alternative to endoscopic laser surgery in patients with difficult exposure, even though there is still a lack of evidence about which procedure provides better vizualization of the vocal cords. This article provides a review of the indications for TORS in laryngeal cancer, the peri-operative morbidity, functional outcomes, and oncological results.
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Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Institute Gustave Roussy, Université Paris-Saclay, Villejuif, France
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13
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Patel KB, Nichols AC, Fung K, Yoo J, MacNeil SD. Treatment of early stage Supraglottic squamous cell carcinoma: meta-analysis comparing primary surgery versus primary radiotherapy. J Otolaryngol Head Neck Surg 2018; 47:19. [PMID: 29506564 PMCID: PMC5839014 DOI: 10.1186/s40463-018-0262-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 01/31/2018] [Indexed: 11/10/2022] Open
Abstract
Objectives For early stage supraglottic squamous cell carcinoma (SCC), single modality treatment either in the form of primary organ preservation surgery alone or radiation alone is recommended. Thus, a definite treatment strategy for early stage supraglottic SCC remains undefined. The primary objective of this study was to conduct a systematic review and meta-analysis comparing the oncologic outcomes of surgery and radiotherapy in early stage (Stage I and II) T1 N0 and T2 N0 supraglottic SCC. Methods Systematic methods were used to identify published and unpublished data. Two reviewers independently screened all titles, abstracts and articles for relevance using predefined criteria. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results Five studies met the inclusion criteria for disease specific mortality with a total of 2864 pooled patients. 5-year disease specific mortality was lower in the surgery group (ORs 0.43, 95% CI 0.31–0.60). Four studies met the inclusion criteria for 5-year overall mortality with a total of 2790 pooled patients. Five-year overall mortality was lower in surgery group (ORs 0.40, 95% CI 0.29–0.55). Conclusions This is the first study to examine the management of early stage supraglottic SCC using meta-analytic methodology. Our results suggest that primary surgery may result in decreased disease specific and overall mortality compared to primary radiotherapy.
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Affiliation(s)
- Krupal B Patel
- Department of Otolaryngology - Head & Neck Surgery, Schulich Medicine & Dentistry, London Health Sciences Centre, Western University, Victoria Hospital, London, ON, Canada
| | - Anthony C Nichols
- Department of Otolaryngology - Head & Neck Surgery, Schulich Medicine & Dentistry, London Health Sciences Centre, Western University, Victoria Hospital, London, ON, Canada
| | - Kevin Fung
- Department of Otolaryngology - Head & Neck Surgery, Schulich Medicine & Dentistry, London Health Sciences Centre, Western University, Victoria Hospital, London, ON, Canada
| | - John Yoo
- Department of Otolaryngology - Head & Neck Surgery, Schulich Medicine & Dentistry, London Health Sciences Centre, Western University, Victoria Hospital, London, ON, Canada
| | - S Danielle MacNeil
- Department of Otolaryngology - Head & Neck Surgery, Schulich Medicine & Dentistry, London Health Sciences Centre, Western University, Victoria Hospital, London, ON, Canada.
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14
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Ho AS, Maghami E. Surgical Perspectives in Head and Neck Cancer. Cancer Treat Res 2018; 174:103-122. [PMID: 29435839 DOI: 10.1007/978-3-319-65421-8_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Head and neck cancer treatment is a complex multidisciplinary undertaking. Cancer cure and survival is a primary goal, yet safe-guarding appearance and function to preserve the quality of life are similarly critical. The head and neck surgeon remains central to multidisciplinary cancer care, with deep knowledge of operative technique and an even deeper understanding of cancer biology. The surgeon models practice based on the highest levels of scientific evidence, but also takes into consideration the approaches that may best suit an individual patient. The surgeon's role moreover spans the life history of a head and neck cancer patient, from diagnosis to surveillance. The intimacy of this role makes the surgeon a trusted and frequent frame of reference for the patient. In this chapter, we provide an overview of the surgeon's role in head and neck cancer management. We discuss surgical perspectives within the multidisciplinary care team and selectively highlight some of the more provocative clinical scenarios in the field.
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Affiliation(s)
- Allen S Ho
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Ellie Maghami
- Department of Surgery, Division of Head and Neck Surgery, City of Hope National Medical Center, Duarte, USA.
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Winiarski P, Lewandowski A, Greczka G, Banaszewski J, Klimza H, Wierzbicka M. Primary and salvage laser surgery of 341 glottic cancers-Comparison of treatment outcomes between University Head Neck Tertiary Referral Center and Local Head Neck Department. Lasers Surg Med 2017; 50:311-318. [PMID: 29135033 DOI: 10.1002/lsm.22759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The main goal was to compare the clinical data of patients with T1 and T2 glottic cancer treated with CO2 transoral laser microlaryngoscopy (TLM) in the Tertiary Referral University Department of Otolaryngology, Head Neck Surgery, Poznan and the local Department of Otolaryngology, Oncology and Maxillofacial Surgery, Bydgoszcz. MATERIAL AND METHODS Unified databases for the 7-year period January 2005-December 2011 were created to compare these two cohorts. The database contained 341 patients: 231 from the tertiary center and 110 from the local department, of which 298 (87%) were men, and 43 (13%) were women. RESULTS Cordectomy type I-IV was performed in 250 (73%) patients, cordectomy type V-VI in 84 (25%) patients, and cordectomy enlarged to epiglottic petiole in 7 (2%) patients. Local recurrence was observed in 96 (28%) cases. Among these cases, 81 (87.5%) patients had salvage surgery: 43 re-cordectomy, 10 open partial laryngectomy, and 28 total laryngectomy. The outcomes for the whole cohort, Tertiary Referral Center and Local Department respectively were as follows: larynx preservation rate was 91.8%, 93.6%, and 88%; 3-year disease specific survival was 97.4%, 97.9%, and 93.3%; 3-year overall survival was 93.5%, 96.6%, and 85.5%; 5-year disease specific survival was 95.2%, 95.2%, and 96.3%; and 5-year overall survival was 84.5%, 88.7%, and 76%, respectively. CONCLUSION Comparison of the cohorts showed that outcomes of primary treatment were similar but there were noticeable differences in salvage treatment efficacy, favoring patients from the Tertiary Referral Center. Lasers Surg. Med. 50:311-318, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Piotr Winiarski
- Department of Otolaryngology, Otolaryngological Oncology and Maxillofacial Surgery, Jan Biziel Second University Hospital, Bydgoszcz, Poland
| | - Artur Lewandowski
- Department of Otolaryngology, Otolaryngological Oncology and Maxillofacial Surgery, Jan Biziel Second University Hospital, Bydgoszcz, Poland
| | - Grażyna Greczka
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Banaszewski
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Hanna Klimza
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Wierzbicka
- Department of Otolaryngology and Oncological Laryngology, Poznan University of Medical Sciences, Poznan, Poland
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Bertolin A, Lionello M, Russo S, Rizzotto G, Lucioni M. Could laser‐assisted dissection of the pre‐epiglottic space affect functional outcome after ESL? Laryngoscope 2017; 128:1371-1378. [DOI: 10.1002/lary.26961] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/04/2017] [Accepted: 09/13/2017] [Indexed: 12/30/2022]
Affiliation(s)
- Andy Bertolin
- Otolaryngology UnitVittorio Veneto HospitalVittorio Veneto Treviso Italy
| | - Marco Lionello
- Otolaryngology UnitVittorio Veneto HospitalVittorio Veneto Treviso Italy
| | - Simone Russo
- Otolaryngology UnitVittorio Veneto HospitalVittorio Veneto Treviso Italy
- Otolaryngology Section, Department of Surgical and Biomedical SciencesUniversity of PerugiaPerugia Italy
| | - Giuseppe Rizzotto
- Otolaryngology UnitVittorio Veneto HospitalVittorio Veneto Treviso Italy
| | - Marco Lucioni
- Otolaryngology UnitVittorio Veneto HospitalVittorio Veneto Treviso Italy
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Landolfo V, Gervasio CF, Riva G, Garzaro M, Audisio R, Pecorari G, Albera R. Prognostic role of margin status in open and CO 2 laser cordectomy for T1a-T1b glottic cancer. Braz J Otorhinolaryngol 2016; 84:S1808-8694(16)30240-3. [PMID: 28110846 PMCID: PMC9442834 DOI: 10.1016/j.bjorl.2016.11.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 10/07/2016] [Accepted: 11/20/2016] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Cordectomy by laringofissure and transoral laser surgery has been proposed for the treatment of early glottic cancer. OBJECTIVES The aim of this retrospective study was to evaluate the prognostic value of margin status in 162 consecutive cases of early glottic carcinoma (Tis-T1) treated with CO2 laser endoscopic surgery (Group A) or laryngofissure cordectomy (Group B), and to compare the oncologic and functional results. METHODS Clinical prognostic factors, local recurrence rate according to margin status, overall survival and disease-free survival were analyzed. RESULTS Margin status is related to recurrence rate in both groups (p<0.05) without significant differences between open and laser cordectomy (p>0.05). The 5 years overall survival and disease-free survival were respectively 90.48% and 85.71% in Group A; 88.14% and 86.44% in Group B (p>0.05). Lower tracheostomy rate, earlier recovery of swallowing function and shorter hospital stay were observed in Group A (p<0.05). CONCLUSIONS Margin status has a prognostic role in T1a-T1b glottic cancer. Transoral laser surgery showed similar oncologic results of open cordectomy, with better functional outcomes.
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Affiliation(s)
- Vincenzo Landolfo
- University of Turin, Surgical Sciences Department, 1st ENT Division, Turin, Italy
| | | | - Giuseppe Riva
- University of Turin, Surgical Sciences Department, 1st ENT Division, Turin, Italy.
| | - Massimiliano Garzaro
- University of Turin, Surgical Sciences Department, 1st ENT Division, Turin, Italy
| | - Rita Audisio
- University of Turin, Surgical Sciences Department, 1st ENT Division, Turin, Italy
| | - Giancarlo Pecorari
- University of Turin, Surgical Sciences Department, 1st ENT Division, Turin, Italy
| | - Roberto Albera
- University of Turin, Surgical Sciences Department, 2nd ENT Division, Turin, Italy
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Wiegand S. Evidence and evidence gaps of laryngeal cancer surgery. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2016; 15:Doc03. [PMID: 28025603 PMCID: PMC5169076 DOI: 10.3205/cto000130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Surgical treatment of laryngeal cancer has been established for decades. In addition to total laryngectomy, which was first performed in 1873, a large number or organ preservation surgical techniques, like open partial laryngectomy, transoral laser microsurgery, and transoral robotic surgery have been developed. Studies on laryngeal cancer surgery are mainly retrospective case series and cohort studies. The evolution of chemoradiation protocols and their analysis in prospective randomized trials have led to an increasing acceptance of non-surgical treatment procedures. In addition to an improvement of prognosis, in recent years the preservation of function and maintenance of life quality after primary therapy of laryngeal cancer has increasingly become the focus of therapy planning. Significant late toxicity after chemoradiation has been identified as an important issue. This leads to a reassessment of surgical concepts and initiation of studies on laryngeal cancer surgery which was additionally stimulated by the advent of transoral robotic surgery in the US. Improving the evidence base of laryngeal cancer surgery by successful establishment of surgical trials should be the future goal.
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Affiliation(s)
- Susanne Wiegand
- Department of Otolaryngology, Head & Neck Surgery, University Hospital of Leipzig, Germany
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19
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Razafindranaly V, Lallemant B, Aubry K, Moriniere S, Vergez S, Mones ED, Malard O, Ceruse P. Clinical outcomes with transoral robotic surgery for supraglottic squamous cell carcinoma: Experience of a French evaluation cooperative subgroup of GETTEC. Head Neck 2015; 38 Suppl 1:E1097-101. [PMID: 26435046 DOI: 10.1002/hed.24163] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transoral, minimally invasive, organ preservation surgeries are increasingly used to treat laryngopharyngeal carcinomas to avoid the toxicity associated with combined chemoradiotherapy (CRT) regimens. This study investigated the efficiency, safety, and functional outcomes of using transoral robotic surgery (TORS) to perform supraglottic laryngectomy (SGL). METHODS This was a multicenter study using a case series with planned data collection from 2009 to 2012 for patients with supraglottic squamous cell carcinomas (SCCs) who underwent an SGL using TORS. RESULTS Eighty-four of the 262 patients underwent TORS for a supraglottic SCC. Within 24 hours of surgery, 24% of the patients began an oral diet. The median use of a feeding tube was 8 days for 76% of other patients. Definitive percutaneous gastrostomy feeding was necessary for 9.5% of the patients. Twenty-four percent of the patients did require a tracheostomy, and the median use was 8 days. One percent of the patients had a definitive tracheostomy. Aspiration pneumonia was observed in 23% of the patients during the postoperative course, and was responsible for the death of 1 patient. Postoperative bleeding occurred in 18% of the patients. Based on the pathology results, 51% of the patients received adjuvant radiation therapy. CONCLUSION TORS for SGL, in the intermediate stage of SCC, provides a safe procedure with good functional outcomes and fast recovery times; however, adverse events are possible. Consequently, this technique requires good selection criteria for the patients to reduce the risk of postoperative complications. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1097-E1101, 2016.
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Affiliation(s)
- Victor Razafindranaly
- Department of Head and Neck Surgery, Hospices Civils de Lyon, University Hospital Lyon-Nord, Lyon, France
| | - Benjamin Lallemant
- Department of Head and Neck Surgery, University Hospital Carémeau, Nîmes, France
| | - Karine Aubry
- Department of Head and Neck Surgery, University Hospital Dupuytren, Limoges, France
| | - Sylvain Moriniere
- Department of Head and Neck Surgery, University Hospital Bretonneau, Tours, France
| | - Sébastien Vergez
- Department of Head and Neck Surgery, University Hospital Larrey, Toulouse, France
| | - Erwan De Mones
- Department of Head and Neck Surgery, University Hospital Pellegrin, Bordeaux, France
| | - Oliver Malard
- Department of Head and Neck Surgery, Nantes University Hospital, Nantes, France
| | - Philippe Ceruse
- Department of Head and Neck Surgery, Hospices Civils de Lyon, University Hospital Lyon-Nord, Lyon, France
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To K, Qureishi A, Mortimore S, De M. The role of primary transoral laser microsurgery in laryngeal cancer: a retrospective study. Clin Otolaryngol 2015; 40:449-55. [DOI: 10.1111/coa.12397] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
- K. To
- Department of Otolaryngology - Head and Neck Surgery; Royal Derby Hospital; Derby UK
| | - A. Qureishi
- Department of Otolaryngology - Head and Neck Surgery; Royal Derby Hospital; Derby UK
| | - S. Mortimore
- Department of Otolaryngology - Head and Neck Surgery; Royal Derby Hospital; Derby UK
| | - M. De
- Department of Otolaryngology - Head and Neck Surgery; Royal Derby Hospital; Derby UK
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21
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Helmstaedter V, Tellkamp R, Majdani O, Warnecke A, Lenarz T, Durisin M. High-frequency jet ventilation for endolaryngotracheal surgery - chart review and procedure analysis from the surgeon's and the anaesthesiologist's point of view. Clin Otolaryngol 2015; 40:341-8. [DOI: 10.1111/coa.12376] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2015] [Indexed: 11/28/2022]
Affiliation(s)
- V. Helmstaedter
- Department of Otorhinolaryngology/Head and Neck Surgery; Medical University of Hannover; Hannover Germany
| | - R. Tellkamp
- Department of Anaesthesiology and Intensive Care Medicine; Medical University of Hannover; Hannover Germany
| | - O. Majdani
- Department of Otorhinolaryngology/Head and Neck Surgery; Medical University of Hannover; Hannover Germany
| | - A. Warnecke
- Department of Otorhinolaryngology/Head and Neck Surgery; Medical University of Hannover; Hannover Germany
| | - T. Lenarz
- Department of Otorhinolaryngology/Head and Neck Surgery; Medical University of Hannover; Hannover Germany
| | - M. Durisin
- Department of Otorhinolaryngology/Head and Neck Surgery; Medical University of Hannover; Hannover Germany
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De Lorenzi D, Bertoncello D, Dentini A. Intraoral diode laser epiglottectomy for treatment of epiglottis chondrosarcoma in a dog. J Small Anim Pract 2015; 56:675-8. [DOI: 10.1111/jsap.12356] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 02/03/2015] [Accepted: 02/09/2015] [Indexed: 11/29/2022]
Affiliation(s)
- D. De Lorenzi
- Veterinary Hospital “I Portoni Rossi”, Interventional Pneumology and ENT Medicine and Surgery Department; 40069 Zola Predosa Bologna Italy
| | - D. Bertoncello
- Veterinary Hospital “I Portoni Rossi”, Interventional Pneumology and ENT Medicine and Surgery Department; 40069 Zola Predosa Bologna Italy
| | - A. Dentini
- Veterinary Clinic “Tyrus”; 05100 Terni Italy
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Basterra J, Esteban F, Reboll R, Menoyo A, Zapater E. Transoral resection of supraglottic tumours using microelectrodes (54 cases). Eur Arch Otorhinolaryngol 2014; 271:2497-502. [DOI: 10.1007/s00405-014-3002-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 03/04/2014] [Indexed: 10/25/2022]
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Chen J, Zhang S, Li Y, Tang Z, Kong W. Hexokinase 2 overexpression promotes the proliferation and survival of laryngeal squamous cell carcinoma. Tumour Biol 2013; 35:3743-53. [PMID: 24363061 DOI: 10.1007/s13277-013-1496-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 11/28/2013] [Indexed: 12/26/2022] Open
Abstract
Proliferating cancer cells preferentially use anaerobic glycolysis rather than oxidative phosphorylation for energy production. Hexokinase 2 (HK2) is highly expressed in many malignant cells and is necessary for anaerobic glycolysis. The role of HK2 in laryngeal squamous cell carcinoma (LSCC) is unknown. In this study, the expression of HK2 in LSCC was investigated and the effect of inhibiting HK2 expression with small hairpin RNA (shRNA) on tumor growth was investigated. Using immunohistochemistry, HK2 expression was assessed in LSCC tissues. Human laryngeal carcinoma Hep-2 cells were stably transfected with a plasmid expressing HK2 shRNA (pGenesil-1.1-HK2) and were compared to control cells with respect to the cell cycle, cell viability, apoptosis, and their ability to form xenograft tumors. HK2 expression was significantly higher in LSCC than in papilloma or glottis polypus. Tumor samples of higher T, N, and TNM stage often had stronger HK2 staining. HK2 shRNA reduced HK2 mRNA, protein levels, and HK activity in Hep-2 cells. HK2 cells expressing shRNA demonstrated a higher G0-G1 ratio, increased apoptosis, and reduced viability. Xenograft tumors derived from cells expressing HK2 shRNA were smaller and had lower proliferation than those from untransfected or control-plasmid-transfected cells. In conclusion, depletion of HK2 expression resulted in reduced xenograft tumor development likely by reducing proliferation, altering the cell cycle, reducing cell viability and activating apoptosis. These data suggest that HK2 plays an important role in the development of LSCC and represents a potential therapeutic target for LSCC.
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Affiliation(s)
- Jian Chen
- Department of Otorhinolaryngology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Number 1277 Jiefang Avenue, Wuhan, Hubei, China
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Ansarin M, Zorzi S, Massaro MA, Tagliabue M, Proh M, Giugliano G, Calabrese L, Chiesa F. Transoral robotic surgery vs transoral laser microsurgery for resection of supraglottic cancer: a pilot surgery. Int J Med Robot 2013; 10:107-12. [PMID: 24288345 DOI: 10.1002/rcs.1546] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 09/13/2013] [Accepted: 09/19/2013] [Indexed: 11/09/2022]
Abstract
BACKGROUND Transoral laser microsurgery (TLM) is a mature approach to supraglottic cancer, while transoral robotic surgery (TORS) is emerging. The present study compared these approaches. METHODS The first 10 patients (2002-2005) given TLM were compared with the first 10 (2007-2011) given TORS for cT1-3 cN0-cN2c supraglottic cancer. RESULTS A feeding tube was used in four TLM and seven TORS patients. Margins were more often positive, but operating times shorter, in TORS. All 10 TORS patients are without evidence of disease, but only six TLM patients remain disease-free after much longer follow-up. TORS was considerably less uncomfortable and fatiguing for the surgeon. CONCLUSIONS TORS seems as safe and effective as TLM. Shorter TORS operating times are probably attributable to prior experience with TLM. For laryngeal exposure, length of tube placement and margin evaluability, TLM was superior; however, this may change as TORS develops and transoral robotic instruments are optimized.
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Affiliation(s)
- Mohssen Ansarin
- Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy
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Goyal N, Yoo F, Setabutr D, Goldenberg D. Surgical anatomy of the supraglottic larynx using the da Vinci robot. Head Neck 2013; 36:1126-31. [DOI: 10.1002/hed.23418] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 04/15/2013] [Accepted: 06/10/2013] [Indexed: 11/09/2022] Open
Affiliation(s)
- Neerav Goyal
- Department of Surgery; Division of Otolaryngology - Head and Neck Surgery; The Pennsylvania State University - Penn State Milton S. Hershey Medical Center; Hershey Pennsylvania
| | - Frederick Yoo
- Department of Surgery; Division of Otolaryngology - Head and Neck Surgery; The Pennsylvania State University - Penn State Milton S. Hershey Medical Center; Hershey Pennsylvania
| | - Dhave Setabutr
- Department of Surgery; Division of Otolaryngology - Head and Neck Surgery; The Pennsylvania State University - Penn State Milton S. Hershey Medical Center; Hershey Pennsylvania
| | - David Goldenberg
- Department of Surgery; Division of Otolaryngology - Head and Neck Surgery; The Pennsylvania State University - Penn State Milton S. Hershey Medical Center; Hershey Pennsylvania
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Hong JC, Kim SW, Lee HS, Han YJ, Park HS, Lee KD. Salvage Transoral Laser Supraglottic Laryngectomy after Radiation Failure: A Report of Seven Cases. Ann Otol Rhinol Laryngol 2013; 122:85-90. [PMID: 23534122 DOI: 10.1177/000348941312200203] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: We evaluated the oncological and functional outcomes of salvage transoral laser supraglottic laryngectomy after radiation failure. In addition, we demonstrated the usefulness of laser surgery in patients with recurrent supraglottic cancer. Methods: Between December 1999 and May 2011, 7 patients (6 men and 1 woman) underwent transoral laser supraglottic laryngectomy after radiation failure. We conducted 4 different types of endoscopic supraglottic laryngectomy. In the cases with lymph node metastasis, we performed neck dissection at the time of laser surgery. Results: All patients had recurrent squamous cell carcinoma confirmed on the surgical specimen. Two patients were classified as having T1 disease, 2 as having T2 disease, and 3 as having T3 disease with preepiglottic space involvement. The 2- and 5-year overall survival rates were 85.7% and 68.6%, respectively. There was a recurrence at 8 months of follow-up after laser surgery in 1 patient; he underwent successful salvage total laryngectomy. The ultimate local control rate was 100%, and the laryngeal preservation rate was 85.7%. The hospitalization times ranged from 2 to 32 days (mean, 15.6 days). The mean decannulation time was 10.7 days (range, 5 to 30 days). All patients started oral feeding within 1 to 3 days after surgery. Conclusions: Salvage transoral laser supraglottic laryngectomy following radiation failure seems a feasible and oncologically safe procedure in recurrent supraglottic cancers ranging from T1 to selected T3 with minimal preepiglottic space involvement. It can be an option for minimally invasive organ preservation surgery with lesser morbidity for recurrent supraglottic cancer.
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Affiliation(s)
- Jong Chul Hong
- Department of Otolaryngology-Head and Neck Surgery, Dong-A University College of Medicine, Busan, Korea
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Arens C. Transoral treatment strategies for head and neck tumors. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2012; 11:Doc05. [PMID: 23320057 PMCID: PMC3544208 DOI: 10.3205/cto000087] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The introduction of transoral endoscopic surgery has initiated a fundamental change in the treatment of head and neck cancer. The endoscopic approach minimizes the intraoperative trauma. Due to the lower burden for the patient and the savings potential these methods have gained wide acceptance. These transoral accesses routes allow experienced surgeons to reduce the morbidity of surgical resection with no deterioration of oncologic results. This suggests a further extension of the indication spectrum and a high growth potential for these techniques and equipment in the coming years. For selected patients with selected tumors the minimally invasive transoral surgery offers improved oncological and functional results. In the present paper, different surgical access routes are presented and their indications discussed.
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Affiliation(s)
- Christoph Arens
- Clinic for Ear, Nose and Throat Medicine, University Hospital Magdeburg, Germany
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Transoral CO2 laser surgery for supraglottic cancer. Eur Arch Otorhinolaryngol 2012; 269:2081-6. [DOI: 10.1007/s00405-012-2016-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 03/26/2012] [Indexed: 10/28/2022]
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Ayuso MA, Martín N, Vendrell M, Blanch JL. [Use of the Kleinsasser suspension laryngoscope to aid orotracheal intubation when supraglottic tumors are present in the larynx]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2011; 58:593-594. [PMID: 22279883 DOI: 10.1016/s0034-9356(11)70149-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Transoral minimally invasive robotic surgery for carcinoma of the pharynx and the larynx. Anticancer Drugs 2011; 22:591-5. [DOI: 10.1097/cad.0b013e3283421868] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rodrigo JP, Coca-Pelaz A, Suárez C. The Current Role of Partial Surgery As a Strategy for Functional Preservation in Laryngeal Carcinoma. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2011. [DOI: 10.1016/j.otoeng.2010.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Suárez C, Rodrigo JP, Silver CE, Hartl DM, Takes RP, Rinaldo A, Strojan P, Ferlito A. Laser surgery for early to moderately advanced glottic, supraglottic, and hypopharyngeal cancers. Head Neck 2011; 34:1028-35. [PMID: 21500310 DOI: 10.1002/hed.21766] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Current practice standards for the treatment of early to moderately advanced laryngeal and hypopharyngeal cancer demand both achievement of cure and preservation of laryngeal structure and function to the greatest extent possible. The oncologic and functional results of transoral laser microsurgery (TLM) for early glottic cancer appear to be comparable to those of radiotherapy, with a higher rate of laryngeal preservation and a lower cost. TLM for early and moderately advanced supraglottic and hypopharyngeal cancers offers similar results with regard to survival and local control to those obtained with open surgical approaches. In addition, functional results of TLM are superior to those of open approaches because tracheotomies are usually avoided, rehabilitation of swallowing is faster, and hospital stay is shorter. TLM, when applicable, has become the preferred modality for surgical treatment of most early to moderately advanced cancers of the larynx and selected tumors of the hypopharynx.
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Affiliation(s)
- Carlos Suárez
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
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López-Álvarez F, Rodrigo JP, Llorente-Pendás JL, Suárez-Nieto C. Cirugía transoral LASER CO2 en tumores avanzados de faringe y laringe. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2011; 62:95-102. [DOI: 10.1016/j.otorri.2010.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2010] [Accepted: 09/03/2010] [Indexed: 11/15/2022]
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López-Álvarez F, Rodrigo JP, Llorente-Pendás JL, Suárez-Nieto C. Transoral laser microsurgery in advanced carcinomas of larynx and pharynx. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s2173-5735(11)70018-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Rodrigo JP, Shah JP, Silver CE, Medina JE, Takes RP, Robbins KT, Rinaldo A, Werner JA, Ferlito A. Management of the clinically negative neck in early-stage head and neck cancers after transoral resection. Head Neck 2010; 33:1210-9. [PMID: 21755564 DOI: 10.1002/hed.21505] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2009] [Revised: 04/14/2010] [Accepted: 05/03/2010] [Indexed: 11/11/2022] Open
Abstract
The decision regarding treatment of the clinically negative neck has been debated extensively. This is particularly true with early-stage tumors for which surgery is the treatment of choice, and the tumor has been resected transorally without a cervical incision. Elective neck dissection in this situation is an additional procedure with potential associated morbidity. The alternative strategy for the clinically negative neck is to "wait and watch." Both an elective neck dissection policy and a "watchful waiting" policy have their proponents. The purpose of this article was for us to review the literature about this subject to try to answer the following question: if the tumor has been resected transorally, should an elective treatment of the neck be performed or is a "watchful waiting" policy safe and adequate? We conclude that, currently, the best available evidence suggests that elective neck dissection does not seem to be superior to the policy of observation without neck surgery, with regard to survival and control of neck disease. This review highlights the need for further well-designed prospective studies that will provide more reliable answers to the debatable issue of the management of the clinically negative neck in such cases.
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Affiliation(s)
- Juan P Rodrigo
- Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain
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Vilaseca I, Bernal-Sprekelsen M, Luis Blanch J. Transoral laser microsurgery for T3 laryngeal tumors: Prognostic factors. Head Neck 2010; 32:929-38. [PMID: 19953612 DOI: 10.1002/hed.21288] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The objective of this study was to evaluate the outcomes of transoral laser microsurgery (TLM) in T3 laryngeal carcinomas and to identify prognostic factors for survival and laryngeal preservation. METHODS This study aimed to provide a retrospective analysis of 147 consecutive patients, evaluating their overall survival, disease-specific survival, laryngectomy-free survival, and function preservation rate. RESULTS Five-year overall, disease-specific, and laryngectomy-free survivals were 53.1%, 70.2%, and 62.3%, respectively. Disease-specific survival differed between glottic and supraglottic tumors (86.3% vs 61.8%; p = .015). Function preservation was 65.5% in supraglottic and 49.1% in glottic tumors (p = .002). Disease-specific survival was not related to pre-epiglottic involvement, cord fixation, or focal cartilage infiltration (p > .05). Vocal cord fixation and cartilage infiltration were independent negative prognostic factors for organ preservation (odds ratio [OR] = 0.184; 95% confidence interval [CI] = 0.082-0.411; p = .000 and OR = 0.331; 95% CI = 0.139-0.789; p = .013, respectively). CONCLUSION Our conclusion is that TLM is a good alternative in a large number of T3 laryngeal tumors, with adequate survival and organ preservation rates above 60%.
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Affiliation(s)
- Isabel Vilaseca
- Department of Oto-Rhino-Laryngology, Hospital Clinic, University of Barcelona, Barcelona, Spain.
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Rodrigo JP, Coca-Pelaz A, Suárez C. [The current role of partial surgery as a strategy for functional preservation in laryngeal carcinoma]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010; 62:231-8. [PMID: 20684940 DOI: 10.1016/j.otorri.2010.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 06/07/2010] [Indexed: 11/26/2022]
Abstract
With the current advances and recent organ preservation protocols for intermediate or advanced stage laryngeal cancer, based on chemotherapy, the role of surgery seemed replaced except for surgical rescue of tumours not responding to these treatments, total laryngectomy being the surgical option. This type of non-surgical treatment is offered as a strategy for organ preservation, as opposed to total laryngectomy. However, we believe that there are two organ-preservation strategies, surgical and non-surgical. A wide spectrum of surgical techniques is available and such techniques lead to excellent results, both oncological and functional (speech and swallowing). The aim of this paper is to present options for organ-preserving surgery for laryngeal cancer. A review of surgical techniques available for functional preservation in cancer of the larynx at intermediate or advanced stage is presented. In addition to classic approaches such as vertical partial laryngectomy and horizontal or supraglottic laryngectomy, options for conservative laryngeal surgery have improved significantly over the past two decades. Minimally invasive surgery, transoral laser surgery, and supracricoid partial laryngectomy have become important laryngeal preservation approaches for patients with laryngeal cancer. Surgery must define its role in the multidisciplinary treatment of advanced cancers of the larynx, which at present often favours (chemo)radiotherapy protocols.
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Affiliation(s)
- Juan Pablo Rodrigo
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Principado de Asturias, España
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Pradhan S, Mehta M, Hakeem A, Tubachi J, Kannan R. Transoral resection of laryngeal and hypopharyngeal cancers. Indian J Surg Oncol 2010; 1:207-11. [PMID: 22930636 PMCID: PMC3421007 DOI: 10.1007/s13193-010-0034-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Accepted: 04/30/2010] [Indexed: 11/26/2022] Open
Abstract
The advent of transoral microlaryngoscopic laser surgery is making a significant impact on treatment decisions in the management of early squamous cancers of the larynx and the hypopharynx. It has, to a great extent replaced the conventional open partial laryngectomy procedures. Moreover many cancers of the larynx or the hypopharynx that were earlier being treated with radiation therapy are now resected transorally with the CO(2) laser. This article focuses on the progress of transoral laser microsurgery in the management of early larygopharyngeal cancers.
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Affiliation(s)
- Sultan Pradhan
- Department of Surgical Oncology, Prince Aly Khan Hospital, Aga Hall, Mazgaon, Mumbai, 400 010 India
| | - Marzi Mehta
- Department of Surgical Oncology, Prince Aly Khan Hospital, Aga Hall, Mazgaon, Mumbai, 400 010 India
| | - Arsheed Hakeem
- Department of Surgical Oncology, Prince Aly Khan Hospital, Aga Hall, Mazgaon, Mumbai, 400 010 India
| | - Jagadish Tubachi
- Department of Surgical Oncology, Prince Aly Khan Hospital, Aga Hall, Mazgaon, Mumbai, 400 010 India
| | - R. Kannan
- Department of Surgical Oncology, Prince Aly Khan Hospital, Aga Hall, Mazgaon, Mumbai, 400 010 India
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Pérez Delgado L, Abeida MEU, de Miguel García F, Peña PA, Tolosana SH, Lisbona Alquézar MP, Tejero-Garcés Galve G, Navarro JS, Martinez-Berganza R, García AO. CO2 laser surgery of supraglottic carcinoma: our experience over 6 years. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/s2173-5735(10)70003-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Karatzanis AD, Psychogios G, Zenk J, Waldfahrer F, Hornung J, Velegrakis GA, Iro H. Evaluation of available surgical management options for early supraglottic cancer. Head Neck 2009; 32:1048-55. [DOI: 10.1002/hed.21289] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Remacle M, Lawson G, Hantzakos A, Jamart J. Endoscopic Partial Supraglottic Laryngectomies. Otolaryngol Head Neck Surg 2009; 141:374-81. [DOI: 10.1016/j.otohns.2009.06.088] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2008] [Revised: 06/09/2009] [Accepted: 06/16/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE: The aim of this study was to evaluate long-term results of endoscopic surgery for supraglottic carcinoma. STUDY DESIGN: Case series with chart review. SETTING: Tertiary care university hospital. SUBJECTS AND METHODS: From 1992 to 2004, 45 patients diagnosed with supraglottic squamous cell carcinoma (two Tis, nine T1N0, 27 T2N0, two T2N1, one T2N2, four T3N0) underwent different types of endoscopic supraglottic laryngectomies according to the European Laryngological Society (ELS) classification: three limited excision (type I); 27 medial without resection of the preepiglottic space (type IIb); one medial with resection of the preepiglottic space (type IIIa); three medial with resection of the preepiglottic space (type IIIb); nine lateral (type IVa); two lateral (type IVb). RESULTS: Overall survival was 93 ± 4 percent (SE) after three years and 89 ± 6 percent (SE) after five years. The median follow-up is 3.7 years. Patients with clinically N0 necks were found to have positive nodes in eight (19%) cases. Two cases of postoperative hemorrhage were controlled by electrocautery. All of the patients without previous treatment for larynx cancer regained swallowing function within five days to three weeks after surgery. Mean duration of hospitalization was 12.5 days. CONCLUSION: Endoscopic partial laryngectomies, as defined by the ELS classification, for selected supraglottic squamous cell carcinoma proved to be an excellent alternative to radiotherapy and open neck surgery.
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Affiliation(s)
- Marc Remacle
- Department of Otorhinolaryngology–Head and Neck Surgery, University Hospital of Louvain at Mont-Godinne
| | - Georges Lawson
- Department of Otorhinolaryngology–Head and Neck Surgery, University Hospital of Louvain at Mont-Godinne
| | - Anastasios Hantzakos
- Department of Otorhinolaryngology–Head and Neck Surgery, University Hospital of Louvain at Mont-Godinne
| | - Jacques Jamart
- Center for Biostatistics, University Hospital of Louvain at Mont-Godinne
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Silver CE, Beitler JJ, Shaha AR, Rinaldo A, Ferlito A. Current trends in initial management of laryngeal cancer: the declining use of open surgery. Eur Arch Otorhinolaryngol 2009; 266:1333-52. [PMID: 19597837 DOI: 10.1007/s00405-009-1028-2] [Citation(s) in RCA: 176] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2009] [Accepted: 06/18/2009] [Indexed: 11/24/2022]
Affiliation(s)
- Carl E Silver
- Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Current world literature. Curr Opin Otolaryngol Head Neck Surg 2009; 17:132-41. [PMID: 19363348 DOI: 10.1097/moo.0b013e32832ad5ad] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yüce İ, Çağlı S, Bayram A, Güney E. Occult metastases from T1–T2 supraglottic carcinoma: role of primary tumor localization. Eur Arch Otorhinolaryngol 2008; 266:1301-4. [DOI: 10.1007/s00405-008-0859-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Accepted: 10/17/2008] [Indexed: 10/21/2022]
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Neck Dissection for Laryngeal Cancer. J Am Coll Surg 2008; 207:587-93. [DOI: 10.1016/j.jamcollsurg.2008.06.337] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Revised: 06/23/2008] [Accepted: 06/23/2008] [Indexed: 11/22/2022]
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