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Cantaffa C, Donvito S, Manto AL, Serafini E, Caffagni R, Luppi MP, Tonelli R, Daniele M, Francesco M. Effect of Aging on Long-Term Functional Outcomes After Open Partial Laryngectomy. Otolaryngol Head Neck Surg 2024; 171:747-755. [PMID: 38946680 DOI: 10.1002/ohn.863] [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: 10/01/2023] [Revised: 03/03/2024] [Accepted: 03/22/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE Open partial horizontal laryngectomies (OPHLs) represent a comparable alternative to total laryngectomy and nonsurgical protocols in selected cases. While short-term functional outcomes of OPHLs have been widely investigated, few have focused on the effect of aging on residual laryngeal structures. STUDY DESIGN Retrospective cohort study. SETTING Tertiary care academic center. METHODS Patients who underwent OPHLs after at least 1 year follow-up and optimal functional rehabilitation were included in the study. Swallowing function was assessed according to PAS (Penetration aspiration scale) and Pooling scores. Spectrogram analysis of voice was conducted according to Yanagihara classification and acoustic parameters were also recorded. Subjective questionnaire data about phonation and swallowing were also recorded. Data obtained were compared among patients according to age at time of surgery, evaluation and duration of follow-up. RESULTS Ninety-seven patients were enrolled with a mean age at surgery and evaluation of 63 and 70 years old, respectively. Median follow-up length was 5 years. OPHL type II was mostly performed. No significant correlation was observed between most of the analyzed variables and patient's age at the time of surgery and at the time of evaluation. Some acoustic parameters were negatively correlated with follow-up length, while Jitter, NHR (Noise-Harmonic Ratio), and Global grade and Roughness were significantly higher in patients >65 years old. CONCLUSION Patients who complete rehabilitation reach equally good results as their younger peers with stability over time. Finally, the effects of aging on residual larynx are of minor entity compared to the nonoperated patients. LEVEL OF EVIDENCE Level IV-retrospective cohort study.
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Affiliation(s)
- Carla Cantaffa
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Sara Donvito
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Alfredo L Manto
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Edoardo Serafini
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliera-Universitaria of Bologna, Bologna, Italy
| | - Rebecca Caffagni
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Maria P Luppi
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Roberto Tonelli
- Respiratory Diseases Unit and Center for Rare Lung Disease, Department of Surgical and Medical Sciences, University Hospital of Modena, Modena, Italy
| | - Marchioni Daniele
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Mattioli Francesco
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy
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Saturno M, Shaari AL, Yun J, Wein LE, Shaari D, Kappauf C, Laitman BM, Chai RL. Outcomes of Supracricoid Partial Laryngectomy Performed in the United States: A Systematic Review. Laryngoscope 2024; 134:3003-3011. [PMID: 38251796 DOI: 10.1002/lary.31273] [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: 07/24/2023] [Revised: 12/09/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024]
Abstract
OBJECTIVE The primary objective of this study was to evaluate oncologic outcomes of all published cases of supracricoid partial laryngectomy (SCPL) performed in the United States. The secondary objective was to assess the functional outcomes associated with this procedure. REVIEW METHODS A systematic review of PubMed, SCOPUS, and Embase for all English-language studies pertaining to SCPL performed in the United States was conducted until August 2021. Primary outcomes included disease-specific survival (DSS), overall survival, and local recurrence rate. Secondary outcomes included larynx preservation rate, gastrostromy tube dependency, days to gastrostomy tube removal, decannulation rate, and days to decannulation. RESULTS A total of six studies were included in the analysis. A total of 113 patients (58.5%) underwent SCPL surgery as a primary treatment method whereas 80 patients (41.5%) underwent SCPL as salvage surgery. The 5-year DSS rates were 87.8% and 100% for primary and salvage procedures, respectively. Approximately 10.3% of patients undergoing a salvage SCPL procedure experienced a local recurrence whereas only 1.85% of primary SCPL procedures resulted in local recurrence. The rates of decannulation following primary and salvage SCPL were 92.7% and 88.1%, respectively. With regard to swallowing, primary and salvage SCPL procedures demonstrated comparably low postoperative gastrostomy tube dependency rates of 3.66% and 4.76%, respectively. CONCLUSIONS SCPL performed in the United States is an effective surgical technique that produces excellent outcomes in qualifying patients, thus validating its viability as an organ-preserving surgical alternative. Laryngoscope, 134:3003-3011, 2024.
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Affiliation(s)
- Michael Saturno
- Thyroid, Head, and Neck Cancer (THANC) Foundation, New York, New York, U.S.A
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Ariana L Shaari
- Thyroid, Head, and Neck Cancer (THANC) Foundation, New York, New York, U.S.A
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Jun Yun
- Thyroid, Head, and Neck Cancer (THANC) Foundation, New York, New York, U.S.A
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Lauren E Wein
- Thyroid, Head, and Neck Cancer (THANC) Foundation, New York, New York, U.S.A
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Diana Shaari
- Thyroid, Head, and Neck Cancer (THANC) Foundation, New York, New York, U.S.A
| | - Catharine Kappauf
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Benjamin M Laitman
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Raymond L Chai
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
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Liu T, Feng H, Liang Z, Xu S, Qin G. Analysis of swallowing and voice-related quality of life in patients after supracricoid partial laryngectomy. Eur Arch Otorhinolaryngol 2024; 281:1857-1864. [PMID: 38183455 PMCID: PMC10942935 DOI: 10.1007/s00405-023-08416-9] [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: 07/07/2023] [Accepted: 12/12/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE This study evaluated the swallowing and voice function of laryngeal cancer patients after Supracricoid Partial Laryngectomy(SCPL), and its influence on quality of life to provide a reference for the selection of surgical methods for laryngeal cancer patients. METHODS Twenty-one patients who received SCPL between April 2015 and November 2021 were included. Each patient's swallowing function and quality of life were assessed through fiberoptic endoscopic examination of swallowing (FEES) and the M.D. Anderson Dysphagia Inventory (MDADI). Fundamental, jitter, shimmer, maximum phonation time (MPT), and voice handicap index-10 (VHI-10) were performed to assess voice function and voice-related quality of life. RESULTS The results of the FEES of the 21 patients were as follows: the rates of pharyngeal residue after swallowing solid, semiliquid, and liquid food were 0%, 28.57%, and 38.09%, respectively; the rates of laryngeal infiltration after swallowing solid, semiliquid, and liquid food were 0%, 28.57%, and 4.76%, respectively; and aspiration did not occur in any of the patients. In the evaluation of swallowing quality of life, the mean total MDADI score was 92.6 ± 6.32. The voice function evaluation showed that the mean F0, jitter, shimmer, and MPT values were 156.01 ± 120.87 (HZ), 11.57 ± 6.21 (%), 35.37 ± 14.16 (%) and 7.85 ± 6.08 (s), respectively. The mean total VHI-10 score was 7.14 ± 4.84. CONCLUSION SCPL provides patients with satisfactory swallowing and voice function. The patients in this study were satisfied with their quality of life in terms of swallowing and voice. SCPL can be used as a surgical method to preserve laryngeal function in patients with laryngeal cancer.
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Affiliation(s)
- Tianzhen Liu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Huajun Feng
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Zhuoping Liang
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Shengen Xu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China
| | - Gang Qin
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, China.
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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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Jia Y, Jiang D, Wu X, He X, Tang J, Sun Z. Analysis of Clinical Treatment of Laryngeal Stenosis After Radiotherapy and Supracricoid Partial Laryngectomy with Cricohyoidoepiglottopexy of Mid-stage and Advanced Laryngeal Cancer. EAR, NOSE & THROAT JOURNAL 2023:1455613221149644. [PMID: 36772810 DOI: 10.1177/01455613221149644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
OBJECTIVE To investigate the possible causes and treatment methods of laryngeal stenosis after radiotherapy following supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP). METHODS The data of seven patients with laryngeal stenosis after radiotherapy following SCPL-CHEP were analysed retrospectively. All patients were diagnosed with mid-stage or advanced laryngeal carcinoma before surgery, and the pathological type was squamous cell carcinoma. All patients met the requirements for SCPL-CHEP surgery. When laryngeal stenosis was found during the post-surgical follow-up period, patients were immediately given the appropriate treatment according to their conditions. RESULTS All seven patients had laryngeal stenosis. One patient underwent granulation resection using a laryngoscope, four patients underwent granulation removal + low-temperature plasma ablation using a laryngoscope, and two patients underwent laryngeal dehiscence surgery + laryngotracheal T-tube placement. All patients recovered well after surgery, with patent airways. CONCLUSION Laryngeal stenosis in patients with mid- and late-stage laryngeal carcinoma is one of the rare complications of SCPL-CHEP. Second-stage laryngeal dilatation can be selected according to the patient's laryngeal stenosis. Most patients with laryngeal stenosis can be extubated completely.
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Affiliation(s)
- Yanxuan Jia
- Department of Otolaryngology Head & Neck Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan Kunming, China
| | - Donghui Jiang
- Department of Otolaryngology Head & Neck Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan Kunming, China
| | - Xiaoguang Wu
- Department of Otolaryngology Head & Neck Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan Kunming, China
| | - Xiaoguang He
- Department of Otolaryngology Head & Neck Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan Kunming, China
| | - Ju Tang
- Department of Otolaryngology Head & Neck Surgery, The First Affiliated Hospital of Kunming Medical University, Yunnan Kunming, China
| | - Zewu Sun
- Department of Otolaryngology,The People' Hospital of Mengzi, Yunnan Mengzi, China
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Colizza A, Ralli M, Di Stadio A, Cambria F, Zoccali F, Cialente F, Angeletti D, Greco A, de Vincentiis M. Outcomes of Laryngeal Cancer Surgery after Open Partial Horizontal Laryngectomies with Lateral Cervical Approach. J Clin Med 2022; 11:jcm11164741. [PMID: 36012980 PMCID: PMC9410219 DOI: 10.3390/jcm11164741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Open partial horizontal laryngectomies (OPHL) are one of the surgical techniques used for the conservative management of laryngeal cancers. The aims of this study are to analyze the oncological and functional results of a group of patients affected by laryngeal squamous cell carcinoma (LSCC) treated with OPHL, performed using a minimally invasive technique. Methods: This is a prospective case−control study. We enrolled 17 consecutive patients with LSCC treated with OPHL through a lateral cervical approach (LCA). Patients were evaluated using their Penetration Aspiration Scale score (liquid, semiliquid and solid) and Voice Handicap Index (VHI) at three different endpoints: 15 days (T1), 3 months (T2), and 6 months (T2) after surgery. Results: The functional outcomes of the LCA are stackable with that of the classical anterior cervical approach in terms of respiration, swallowing, and speech. One-way ANOVA was performed to evaluate the variances of PAS and VHI scores at the three different observation points. No statistically significant differences were observed between OPHL- PAS scores for liquid (p = 0.1) at the three different observation points. A statistically significant improvement was observed in the OPHL- PAS score for semisolids and solids (p < 0.00001) between T1 and T3 (p = 0.0001) and for solids between T2 and T3 (p < 0.00001). The improvement of VHI-10 was statistically significative (p < 0.00001) at the three different observation points (T1−T2 and T2−T3). Conclusion: The LCA is a potential approach for laryngeal surgery in selected cases. The preoperative staging and planning are of the utmost importance to ensure oncological radicality. The main advantage of this approach is the preservation of the healthy tissues surrounding the larynx and the functional and oncological outcomes are stackable with the classic anterior cervical approach.
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Affiliation(s)
- Andrea Colizza
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
- Correspondence: ; Tel.: +39-340-380-7820
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
| | - Arianna Di Stadio
- Department GF Ingrassia, University of Catania, 95125 Catania, Italy
| | - Francesca Cambria
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
| | - Federica Zoccali
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
| | - Fabrizio Cialente
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
| | - Diletta Angeletti
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, 00161 Roma, Italy
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Postoperative results and the effects of extended partial laryngectomy on the quality of life. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.834031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yu L, Zheng M, Ren J, Hu J, Lu D, Yang H. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy for patients with laryngeal cicatricial stenosis: Safety and efficacy. Head Neck 2021; 43:2634-2643. [PMID: 33942931 DOI: 10.1002/hed.26734] [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: 08/13/2020] [Revised: 02/21/2021] [Accepted: 04/22/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND We assessed the safety and efficacy of supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCL-CHEP) in patients with laryngeal cicatricial stenosis. METHODS Sixteen patients receiving SCL-CHEP for severe laryngeal cicatricial stenosis between 2017 and 2018 were reviewed. Decannulation rate and tracheostomy closure time were used to evaluate efficacy. The Voice Handicap Index-10 (VHI-10), Voice-related Quality of Life (V-RQOL) scale and Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale were used to assess vocal function. Fiberoptic endoscopic evaluation of swallowing (FEES) was performed and the Penetration-Aspiration Scale (PAS), Eating Assessment Tool-10 (EAT-10), and Swallow Quality of Life Questionnaire (SWAL-QOL) were used to assess swallowing function. RESULTS Thirteen patients (81.25%) were decannulated successfully. The average tracheostomy closure time was 45.15 days. There was no observed postoperative complications or recurrence of stenosis. VHI-10 and V-RQOL scores showed significantly improved V-RQOL (p < 0.05). FEES-PAS, EAT-10, and SWAL-QOL showed no swallowing function damage. CONCLUSIONS SCL-CHEP is effective and safe for patients with severe laryngeal cicatricial stenosis. Accurate pre-procedure evaluation is especially important for patient selection and surgical success.
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Affiliation(s)
- Lingyu Yu
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Meijun Zheng
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jia Ren
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Juanjuan Hu
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Dan Lu
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Hui Yang
- Department of Otolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, China
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Rehabilitation following open partial laryngeal surgery: key issues and recommendations from the UK evidence based meeting on laryngeal cancer. The Journal of Laryngology & Otology 2019; 133:177-182. [PMID: 30983563 DOI: 10.1017/s0022215119000483] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND It is recognised that a limited cohort of patients receive open partial laryngeal surgery in specific centres within the UK, so sharing information around key clinical issues and recommendations for practice is necessary to improve outcomes. METHODS This position statement provides practice recommendations based on a synthesis of the available evidence presented at the 12th Evidence Based Management day on 'Laryngeal Cancer' and the ensuing discussions. Literature searches and critical analysis of available evidence were undertaken and triangulated with the clinical experience of the authors to develop these recommendations.Results and conclusionThis paper presents a comprehensive overview of challenges that the multidisciplinary team may encounter. It provides recommendations for swallow and speech rehabilitation after open partial laryngectomy, and suggests practical ways that these issues may be addressed pre- and post-operatively.
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Aydil U, Akmansu M, Gümüşay Ö, Eravcı FC, Bakkal FK, Yazıcı Ö, Kızıl Y, Zorlu ME, Yıldız R, Köybaşıoğlu A. Failure of Concurrent Chemoradiotherapy for Organ Preservation in Laryngeal Cancer: Survival Outcomes and Recurrence Patterns. EAR, NOSE & THROAT JOURNAL 2019; 98:E92-E96. [PMID: 30983390 DOI: 10.1177/0145561319839788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although definitive chemoradiation (CRT) has been used for locally advanced laryngeal cancer for more than 2 decades, studies focusing on CRT failures in advanced laryngeal cancer are scarce. In this study, we aimed to determine the failure patterns and the survival outcomes in the patients who had recurrence after concurrent CRT for laryngeal cancer. Clinical records of the patients who had definitive concurrent CRT for laryngeal cancer between 2001 and 2014 at a tertiary referral center were reviewed. The end points of the study were 1-, 2-, and 3-year overall survival (OS) and disease-specific survival (DSS).In our results, there were 48 failures and the mean time period from the first diagnosis of disease to the diagnosis of recurrence was 18.0 months (range 2-72; standard deviation: 15.6). The most common recurrence pattern was local recurrence in 21 (47.9%) patients followed by regional recurrence in 11 (22.9%) patients. The 1 and 3 years OS rates were 41.7%, and 19.2% for the entire cohort, and 64.5%, and 29.7% for the patients who had not systemic recurrence at presentation of recurrence, respectively. The 1 and 3 years DSS rates were 43.5%, and 20.0% for the entire cohort, and 69.0%, and 31.8% for the patients who had not systemic recurrence at presentation of recurrence, respectively. All patients who had systemic recurrence initially (n = 13) died within 9 months (median = 4 months, range: 1-9 months). This study reveals that survival outcomes are unfavorable in the CRT failures and careful patient selection is critical to minimize failures. In the presence of systemic recurrence, disease course is aggressive.
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Affiliation(s)
- Utku Aydil
- 1 Department of Otorhinolaryngology, Head & Neck Surgery, Gazi University School of Medicine, Ankara, Turkey
| | - Müge Akmansu
- 2 Department of Radiation Oncology, Head & Neck Surgery, Gazi University School of Medicine, Ankara, Turkey
| | - Özge Gümüşay
- 3 Department of Medical Oncology, Head & Neck Surgery, Gazi University School of Medicine, Ankara, Turkey
| | - Fakih Cihat Eravcı
- 1 Department of Otorhinolaryngology, Head & Neck Surgery, Gazi University School of Medicine, Ankara, Turkey
| | - Faruk Kadri Bakkal
- 1 Department of Otorhinolaryngology, Head & Neck Surgery, Gazi University School of Medicine, Ankara, Turkey
| | - Ömer Yazıcı
- 2 Department of Radiation Oncology, Head & Neck Surgery, Gazi University School of Medicine, Ankara, Turkey
| | - Yusuf Kızıl
- 1 Department of Otorhinolaryngology, Head & Neck Surgery, Gazi University School of Medicine, Ankara, Turkey
| | - Mehmet Ekrem Zorlu
- 1 Department of Otorhinolaryngology, Head & Neck Surgery, Gazi University School of Medicine, Ankara, Turkey
| | - Ramazan Yıldız
- 3 Department of Medical Oncology, Head & Neck Surgery, Gazi University School of Medicine, Ankara, Turkey
| | - Ahmet Köybaşıoğlu
- 4 Department of Otorhinolaryngology, Head & Neck Surgery, Lösev Ankara Hospital, Ankara, Turkey
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Miyamaru S, Minoda R, Kodama N. Long‐term changes in vocal function after supracricoid partial laryngectomy with cricohyoidoepiglottopexy for laryngeal cancer. Head Neck 2018; 41:139-145. [DOI: 10.1002/hed.25487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 03/09/2018] [Accepted: 07/05/2018] [Indexed: 11/08/2022] Open
Affiliation(s)
- Satoru Miyamaru
- Department of Otolaryngology—Head and Neck SurgeryGraduate School of Medicine, Kumamoto University Kumamoto Japan
| | - Ryosei Minoda
- Department of Otolaryngology—Head and Neck SurgeryGraduate School of Medicine, Kumamoto University Kumamoto Japan
- Department of Otolaryngology—Head and Neck SurgeryMiddle Ear and Inner Ear Surgical Center, JCHO Kumamoto General Hospital Yatsushiro Japan
| | - Narihiro Kodama
- Department of Otolaryngology—Head and Neck SurgeryGraduate School of Medicine, Kumamoto University Kumamoto Japan
- Department of RehabilitationKumamoto Health Science University Kumamoto Japan
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Xia X, Zhu YY, Diao WW, Zhu XL, Shi XH, Li WY, Gao ZQ, Li GJ, Chen XM. Matched-pair analysis of survival in the patients with T3 laryngeal squamous cell carcinoma treated with supracricoid partial laryngectomy or total laryngectomy. Onco Targets Ther 2018; 11:7947-7953. [PMID: 30519036 PMCID: PMC6235336 DOI: 10.2147/ott.s175358] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The survival outcomes between supracricoid partial laryngectomy (SCPL) and total laryngectomy (TL) were compared in the groups of matched-pair patients with T3 laryngeal squamous cell carcinoma (LSCC). Methods Patients with T3 LSCC were matched based on prognostic factors. The Kaplan–Meier curve and the Cox proportional hazards model were used for analysis on survival. Results A total of 212 patients with T3 LSCC were included after matching (106 underwent SCPL and 106 underwent TL). Multivariable analysis showed no differences in overall survival (hazard risk [HR]=1.15; 95% CI: 0.79–1.67; P=0.47), disease-specific survival (HR=1.11; 95% CI: 0.69–1.80; P=0.66), and recurrence-free survival (HR=1.07; 95% CI: 0.68–1.68; P=0.77) between the SCPL group and TL group. Conclusion SCPL provides reliable therapeutic outcomes and can be used to avoid a TL surgery in some patients with advanced primary laryngeal cancer.
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Affiliation(s)
- Xin Xia
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Ying-Ying Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Wen-Wen Diao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Xiao-Li Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Xiao-Hua Shi
- Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wu-Yi Li
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Zhi-Qiang Gao
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Guo-Jun Li
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
| | - Xing-Ming Chen
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China,
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Gallo O, Locatello LG, Larotonda G, Napoleone V, Cannavicci A. Nomograms for prediction of postoperative complications in open partial laryngeal surgery. J Surg Oncol 2018; 118:1050-1057. [DOI: 10.1002/jso.25232] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 08/20/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Oreste Gallo
- Department of Surgery and Translational Medicine; Division of Otolaryngology, University of Florence; Firenze Italy
| | - Luca Giovanni Locatello
- Department of Surgery and Translational Medicine; Division of Otolaryngology, University of Florence; Firenze Italy
| | - Guglielmo Larotonda
- Department of Surgery and Translational Medicine; Division of Otolaryngology, University of Florence; Firenze Italy
| | - Vincenzo Napoleone
- Biodigita - Biostatistical Analysis Section, Gorgia Study Institute; Firenze Italy
| | - Angelo Cannavicci
- Department of Surgery and Translational Medicine; Division of Otolaryngology, University of Florence; Firenze Italy
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Morisod B, Guinchard AC, Gorphe P, Schweizer V, Sandu K, Simon C. Transoral robotic-assisted supracricoid partial laryngectomy with cricohyoidoepiglottopexy: Procedure development and outcomes of initial cases. Head Neck 2018; 40:2254-2262. [DOI: 10.1002/hed.25332] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 01/14/2018] [Accepted: 04/19/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Benoît Morisod
- Department of Otolaryngology - Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois (CHUV); University of Lausanne; Lausanne Suisse
| | - Anne-Claude Guinchard
- Department of Otolaryngology - Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois (CHUV); University of Lausanne; Lausanne Suisse
| | - Philippe Gorphe
- Department of Head and Neck Oncology; Institute Gustave Roussy; Villejuif France
| | - Valerie Schweizer
- Department of Otolaryngology - Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois (CHUV); University of Lausanne; Lausanne Suisse
| | - Kishore Sandu
- Department of Otolaryngology - Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois (CHUV); University of Lausanne; Lausanne Suisse
| | - Christian Simon
- Department of Otolaryngology - Head and Neck Surgery, Centre Hospitalier Universitaire Vaudois (CHUV); University of Lausanne; Lausanne Suisse
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15
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Saraniti C, Speciale R, Gallina S, Salvago P. Prognostic role of resection margin in open oncologic laryngeal surgery: survival analysis of a cohort of 139 patients affected by squamous cell carcinoma. Braz J Otorhinolaryngol 2018; 85:603-610. [PMID: 30213593 PMCID: PMC9443017 DOI: 10.1016/j.bjorl.2018.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/16/2018] [Accepted: 04/25/2018] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION The treatment of laryngeal squamous cell carcinoma needs accurate risk stratification, in order to choose the most suitable therapy. The prognostic significance of resection margin is still highly debated, considering the contradictory results obtained in several studies regarding the survival rate of patients with a positive resection margin. OBJECTIVE To evaluate the prognostic role of resection margin in terms of survival and risk of recurrence of primary tumour through survival analysis. METHODS Between 2007 and 2014, 139 patients affected by laryngeal squamous cell carcinoma underwent partial or total laryngectomy and were followed for mean of 59.44±28.65 months. Resection margin status and other variables such as sex, age, tumour grading, pT, pN, surgical technique adopted, and post-operative radio- and/or chemotherapy were investigated as prognostic factors. RESULTS 45.32% of patients underwent total laryngectomy, while the remaining subjects in the cohort underwent partial laryngectomy. Resection margins in 73.39% of samples were free of disease, while in 21 patients (15.1%) anatomo-pathological evaluation found one of the margins to be close; in 16 subjects (11.51%) an involved resection margin was found. Only 6 patients (4.31%) had a recurrence, which occurred in 83.33% of these patients within the first year of follow-up. Disease specific survival was 99.24% after 1 year, 92.4% after 3 years, and 85.91% at 5 years. The multivariate analysis of all covariates showed an increased mortality rate only with regard to pN (HR=5.043; p=0.015) and recurrence (HR=11.586; p=0.012). Resection margin did not result an independent predictor (HR=0.757; p=0.653). CONCLUSIONS Our study did not recognize resection margin as an independent prognostic factor; most previously published papers lack unanimous, methodological choices, and the cohorts of patients analyzed are not easy to compare. To reach a unanimous agreement regarding the prognostic value of resection margins, it would be necessary to carry out meta-analyses on studies sharing definition of resection margin, methodology and post-operative therapeutic choices.
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Affiliation(s)
- Carmelo Saraniti
- Università degli Studi di Palermo, Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Sezione di Otorinolaringoiatria, Palermo, Italy.
| | - Riccardo Speciale
- Università degli Studi di Palermo, Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Sezione di Otorinolaringoiatria, Palermo, Italy
| | - Salvatore Gallina
- Università degli Studi di Palermo, Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Sezione di Otorinolaringoiatria, Palermo, Italy
| | - Pietro Salvago
- Università degli Studi di Palermo, Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Sezione di Otorinolaringoiatria, Palermo, Italy
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16
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Leone CA, Capasso P, Topazio D, Russo G. Supracricoid laryngectomy for recurrent laryngeal cancer after chemoradiotherapy: a systematic review and meta-analysis. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 36:439-449. [PMID: 28177326 PMCID: PMC5317122 DOI: 10.14639/0392-100x-1063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 09/21/2016] [Indexed: 11/23/2022]
Abstract
Residual or recurrent laryngeal cancer after irradiation is a difficult clinical problem with a rate that ranges from 13% to 36% of cases. Supracricoid laryngectomy (SCL) with cricohyoidopexy (CHP) or cricohyoidoepiglottopexy (CHEP) provide reliable oncological and functional results for selected primary and recurrent patients with glottic and supraglottic carcinomas. We conducted a systematic review and meta-analysis to assess the oncological and functional outcomes of patients treated with open partial horizontal laryngectomy types IIa and IIb (CHEP, CHP) in terms of the recurrence of squamocellular cancer of the larynx after radiotherapy failure. The databases searched included MEDLINE, PubMed and EMBASE (from January 1990 to December 2015, English language). The meta-analysis was performed with a mixed random effects model using the DerSimonian and Laird method. The heterogeneity was measured with the I2 statistic. Fourteen papers out of 276 were included and comprised a total of 291 patients. The five-year overall survival was 80.2% (CI 0.719-0.885; I2 = 62%; p = 0.003), and the 5-year disease-free survival was 89.5% (CI 0.838-0.952; I2 = 52%; p = 0.022). The indications for SCL after the failure of radiation therapy (RT) were similar to those specified for previously untreated patients. We therefore hypothesised that careful assessment of tumour extension might be responsible for the high 5-year OS and 5-year DFS. The early postoperative recovery outcomes indicated that the mean time until decannulation was 35.6 days (CI 24.3-46.9; I2 = 95%; p < 0.001), and the mean time until nasogastric tube (NGT) or percutaneous endoscopic gastrostomy (PEG) removal was 28.3 days (CI 22.7-33.8; I2 = 86%; p< = 0.001). These data are according to authors who prefer the initial removal of the NGT and the initiation of oral alimentation with a tracheostomy tube to protect and clean the airways and permit the suction of any residual food that might be present.
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Affiliation(s)
- C A Leone
- Otolaryngology Head and Neck Surgery Unit of "Azienda Ospedaliera di Rilievo Nazionale dei Colli, Ospedale Monaldi", Naples, Italy
| | - P Capasso
- Otolaryngology Head and Neck Surgery Unit of "Azienda Ospedaliera di Rilievo Nazionale dei Colli, Ospedale Monaldi", Naples, Italy
| | - D Topazio
- Otolaryngology Head and Neck Surgery Unit of "Azienda Ospedaliera di Rilievo Nazionale dei Colli, Ospedale Monaldi", Naples, Italy
| | - G Russo
- Otolaryngology Head and Neck Surgery Unit of "Azienda Ospedaliera di Rilievo Nazionale dei Colli, Ospedale Monaldi", Naples, Italy
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17
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Dysphagia Evaluation and Treatment After Head and Neck Surgery and/or Chemoradiotherapy of Head and Neck Malignancy. Dysphagia 2018. [DOI: 10.1007/174_2018_179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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18
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Mannelli G, Lazio MS, Luparello P, Gallo O. Conservative treatment for advanced T3-T4 laryngeal cancer: meta-analysis of key oncological outcomes. Eur Arch Otorhinolaryngol 2017; 275:27-38. [PMID: 29119321 DOI: 10.1007/s00405-017-4799-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 11/02/2017] [Indexed: 12/12/2022]
Abstract
GOAL Controversies exist regarding the treatment of advanced laryngeal carcinomas. The purpose of this systematic review was to evaluate the oncologic outcomes of both transoral laser and open partial laryngectomies for advanced (T3-T4) squamous cell laryngeal cancers management. INTRODUCTION A systematic review of literature was led searching for articles mentioning the following terms: advanced (T3-T4) laryngeal cancer AND laser; AND open partial laryngectomy; AND transoral laser microsurgery; AND cordectomy; AND conservative surgery; AND tracheohyoidopexy or tracheohyoidoepiglottopexy; AND supratracheal partial laryngectomy; AND supracricoid partial laryngectomy; AND cricohyoidopexy or cricohyoidoepiglottopexy. Then a quantitative analysis was carried on papers published after 1980. DISCUSSION The search identified 110 publications, and a total of 21 articles satisfied inclusion criteria and were selected for quantitative synthesis. 10 out of 21 studies had a good quality score, 10 were fair and only one rated a poor score. The pooled disease-free survival (DFS) was 79% (95% CI 74-85), and pooled overall survival (OS) was 71% (95% CI 64-78) at 5 years from all 1921 patients included in the study, with significant heterogeneity (I 2 = 89.7% and I 2 = 90.4%), respectively. Significant heterogeneity value (p = 0.118) was seen by comparing transoral laser and open partial laryngectomies in terms of DFS. CONCLUSION The two surgical techniques are both valid conservative surgical options for advanced laryngeal cancer treatment.
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Affiliation(s)
- Giuditta Mannelli
- Clinic of Otorhinolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, University of Florence, Largo Brambilla 3, 50134, Firenze, Italy.
| | - Maria Silvia Lazio
- Clinic of Otorhinolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, University of Florence, Largo Brambilla 3, 50134, Firenze, Italy
| | - Paolo Luparello
- Clinic of Otorhinolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, University of Florence, Largo Brambilla 3, 50134, Firenze, Italy
| | - Oreste Gallo
- Clinic of Otorhinolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, University of Florence, Largo Brambilla 3, 50134, Firenze, Italy
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19
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Hemmaoui B, Sahli M, Errami N, Rouihi A, Bahalou MH, Benchaifai I, Ennouali A, Britel S, Nakkabi I, Jahidi A, Zalagh M, Ouaraini S, Benariba F. [Supracricoid partial laryngectomy (SCPL) with either cricohyoidoepiglottopexy (CHEP): our experience with 16 cases]. Pan Afr Med J 2017; 27:191. [PMID: 28904716 PMCID: PMC5579443 DOI: 10.11604/pamj.2017.27.191.11955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Accepted: 05/31/2017] [Indexed: 11/11/2022] Open
Abstract
La chirurgie partielle du larynx avec reconstruction par crico-hyoïdo-épiglottopexie (CHEP) s’adresse essentiellement aux cancers du plan glottique permettant une préservation satisfaisante des rôles physiologiques et un contrôle carcinologique local également satisfaisant. L’objectif de notre étude est d’analyser les résultats fonctionnels et carcinologiques de cette chirurgie. Il s’agit d’une étude rétrospective incluant l’ensemble des patients ayant bénéficié d’une chirurgie partielle du larynx avec reconstruction CHEP entre 2011 et 2014 dans notre institution. Nous avons analysé les données épidémiologiques, les particularités chirurgicales, les suites fonctionnels et le contrôle carcinologique de la maladie. Au total, 16 patients ont été inclus dans cette étude. Tous nos patients avaient un carcinome épidermoïde du plan glottique classé T1 ou T2. Les suites fonctionnels étaient généralement simples surtout dans les cas où La conservation des 2 unités cricoaryténoïdiennes était possible (75% des cas) mais avec toutefois des complications post-opératoires notées dans 31,25%. Le contrôle carcinologique était satisfaisant, une seule récidive locale a été objectivée dans notre étude. La chirurgie partielle du larynx avec reconstruction par crico-hyoïdo-épiglottopexie (CHEP) est une chirurgie sure avec une préservation des rôles physiologiques et une qualité de vie satisfaisante, elle permet également un bon contrôle carcinologique sous réserve de bien cerner les indications.
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Affiliation(s)
- Bouchaib Hemmaoui
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Mohamed Sahli
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Noureddine Errami
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Ahmed Rouihi
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Mohamed Habib Bahalou
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Ilias Benchaifai
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Amine Ennouali
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Sara Britel
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Ismail Nakkabi
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Ali Jahidi
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Mohamed Zalagh
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Saloua Ouaraini
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
| | - Fouad Benariba
- Service d'ORL et Chirurgie Cervico-faciale, Hôpital d'Instruction Militaire Mohamed V, Rabat, Maroc
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20
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Follow-up program in head and neck cancer. Crit Rev Oncol Hematol 2017; 113:151-155. [PMID: 28427504 DOI: 10.1016/j.critrevonc.2017.03.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 02/15/2017] [Accepted: 03/11/2017] [Indexed: 02/03/2023] Open
Abstract
Follow-up program in head and neck cancer (HNC) is an important issue in patients management. It represents the major dilemma in daily practice clinic. Many guidelines have been published in order to better define the best clinical protocol, but a consensus has not been attained yet. We constructed a follow-up program based on specific primary subsite, to standardize patients surveillance after treatment of HNC.
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21
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Crosetti E, Caracciolo A, Arrigoni G, Fantini M, Sprio AE, Berta GN, Succo G. Management of T4a Laryngeal Cancer. CURRENT OTORHINOLARYNGOLOGY REPORTS 2017. [DOI: 10.1007/s40136-017-0142-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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22
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Ahn SH, Hong HJ, Kwon SY, Kwon KH, Roh JL, Ryu J, Park JH, Baek SK, Lee GH, Lee SY, Lee JC, Chung MK, Joo YH, Ji YB, Hah JH, Kwon M, Park YM, Song CM, Shin SC, Ryu CH, Lee DY, Lee YC, Chang JW, Jeong HM, Cho JK, Cha W, Chun BJ, Choi IJ, Choi HG, Lee KD. Guidelines for the Surgical Management of Laryngeal Cancer: Korean Society of Thyroid-Head and Neck Surgery. Clin Exp Otorhinolaryngol 2017; 10:1-43. [PMID: 28043099 PMCID: PMC5327593 DOI: 10.21053/ceo.2016.01389] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 10/24/2016] [Indexed: 01/08/2023] Open
Abstract
Korean Society of Thyroid-Head and Neck Surgery appointed a Task Force to develop clinical practice guidelines for the surgical treatment of laryngeal cancer. This Task Force conducted a systematic search of the EMBASE, MEDLINE, Cochrane Library, and KoreaMed databases to identify relevant articles, using search terms selected according to the key questions. Evidence-based recommendations were then created on the basis of these articles. An external expert review and Delphi questionnaire were applied to reach consensus regarding the recommendations. The resulting guidelines focus on the surgical treatment of laryngeal cancer with the assumption that surgery is the selected treatment modality after a multidisciplinary discussion in any context. These guidelines do not, therefore, address non-surgical treatment such as radiation therapy or chemotherapy. The committee developed 62 evidence-based recommendations in 32 categories intended to assist clinicians during management of patients with laryngeal cancer and patients with laryngeal cancer, and counselors and health policy-makers.
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Affiliation(s)
- Korean Society of Thyroid-Head and Neck Surgery Guideline Task Force
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Catholic Kwandong University College of Medicine, Incheon, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, University of Ulsan College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Daejin Medical Center, Bundang Jesaeng Hospital, Seongnam, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Wonkwang University School of Medicine, Iksan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Inje University College of Medicine, Busan, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Seonam University College of Medicine, Goyang, Korea
- Department of Otorhinolaryngology Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea
| | - Soon-Hyun Ahn
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Jun Hong
- Department of Otorhinolaryngology Head and Neck Surgery, Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Soon Young Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Kee Hwan Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Jong-Lyel Roh
- Department of Otorhinolaryngology Head and Neck Surgery, University of Ulsan College of Medicine, Seoul, Korea
| | - Junsun Ryu
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Jun Hee Park
- Department of Otorhinolaryngology Head and Neck Surgery, Chosun University College of Medicine, Gwangju, Korea
| | - Seung-Kuk Baek
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Guk Haeng Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Sei Young Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jin Choon Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology Head and Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Hoon Joo
- Department of Otorhinolaryngology Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Bae Ji
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Jeong Hun Hah
- Department of Otorhinolaryngology Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Minsu Kwon
- Department of Otorhinolaryngology Head and Neck Surgery, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young Min Park
- Department of Otorhinolaryngology Head and Neck Surgery, Daejin Medical Center, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Chang Myeon Song
- Department of Otorhinolaryngology Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea
| | - Sung-Chan Shin
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Chang Hwan Ryu
- Department of Otorhinolaryngology Head and Neck Surgery, National Cancer Center, Goyang, Korea
| | - Doh Young Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Young Chan Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Won Chang
- Department of Otorhinolaryngology Head and Neck Surgery, Chungnam National University School of Medicine, Daejeon, Korea
| | - Ha Min Jeong
- Department of Otorhinolaryngology Head and Neck Surgery, Wonkwang University School of Medicine, Iksan, Korea
| | - Jae-Keun Cho
- Department of Otorhinolaryngology Head and Neck Surgery, Inje University College of Medicine, Busan, Korea
| | - Wonjae Cha
- Department of Otorhinolaryngology Head and Neck Surgery, Pusan National University School of Medicine, Busan, Korea
| | - Byung Joon Chun
- Department of Otorhinolaryngology Head and Neck Surgery, Seonam University College of Medicine, Goyang, Korea
| | - Ik Joon Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology Head and Neck Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Kang Dae Lee
- Department of Otorhinolaryngology Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea
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23
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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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24
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Kılıç C, Tunçel Ü, Kaya M, Cömert E, Özlügedik S. Swallowing and Aspiration: How Much Is Affected by the Number of Arytenoid Cartilages Remaining After Supracricoid Partial Laryngectomy? Clin Exp Otorhinolaryngol 2016; 10:344-348. [PMID: 27440130 PMCID: PMC5678037 DOI: 10.21053/ceo.2015.01837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 06/07/2016] [Accepted: 06/10/2016] [Indexed: 11/22/2022] Open
Abstract
Objectives The aim of this study was to compare the effect of the presence of one or two arytenoids on early/late period swallowing-aspiration functions. Methods Supracricoid partial laryngectomy (SCPL) with the diagnosis of laryngeal cancer between 2012 and 2014 were retrospectively evaluated. The patients were categorized into two groups as follows: group I, patients who underwent SCPL with one arytenoid cartilage and group II, patients who underwent SCPL with two arytenoid cartilages. The time of decannulation and oral feeding onset, and swallowing-aspiration functions were evaluated and compared in the early nutritional period, first, and third months. Results There was no significant correlation between decannulation time and swallowing-aspiration. The aspiration rates in group I and group II were similar and there was no significant difference in oral feeding onset and aspiration grades in the first and third months between both groups. Conclusion We found similar oncological and functional outcomes in SCPL which protected one or two arytenoid cartilages. Therefore we suggest to be performed one arytenoid cartilage SCPL in selected patients who was advance stage and tumor volume over with larynx cancer.
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Affiliation(s)
- Caner Kılıç
- Department of Otorhinolaryngology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Ümit Tunçel
- Department of Otorhinolaryngology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Metin Kaya
- Batman Government Hospital, Batman, Turkey
| | - Ela Cömert
- Department of Otorhinolaryngology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
| | - Samet Özlügedik
- Department of Otorhinolaryngology, Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey
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Ferreira E, Nabuco Araújo C, Agostinho S, Santos AR. Cricohyoidoepiglottopexy in Laryngeal Trauma. Otolaryngol Head Neck Surg 2016; 155:886-887. [DOI: 10.1177/0194599816659059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 06/21/2016] [Indexed: 01/29/2023]
Affiliation(s)
- Eduardo Ferreira
- Otorhinolaryngology Department, Hospital de Santa Maria, Lisbon, Portugal
| | | | - Sandra Agostinho
- Otorhinolaryngology Department, Hospital Divino Espírito Santo, Ponta Delgada, Portugal
| | - Ana Rita Santos
- Otorhinolaryngology Department, Hospital de Santa Maria, Lisbon, Portugal
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Crosetti E, Fantini M, Arrigoni G, Salonia L, Lombardo A, Atzori A, Panetta V, Schindler A, Bertolin A, Rizzotto G, Succo G. Telephonic voice intelligibility after laryngeal cancer treatment: is therapeutic approach significant? Eur Arch Otorhinolaryngol 2016; 274:337-346. [PMID: 27435595 DOI: 10.1007/s00405-016-4217-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 07/14/2016] [Indexed: 11/21/2022]
Abstract
The aim was to investigate telephonic voice intelligibility in patients treated for laryngeal cancer using different approaches. In total, 90 patients treated for laryngeal cancer using different approaches and 12 healthy volunteers were recruited. Each patient and each healthy control read a list of words and sentences during a telephone call. Six auditors listened to each telephonic recording and transcribed the words and sentences they understood. Mean intelligibility rates for each treatment were assessed and compared. Regarding words, the poorest intelligibility was noted for type II open partial horizontal laryngectomies, followed by total laryngectomies. The best intelligibility was found for transoral laser microsurgery, followed by radiotherapy alone. For sentences, the poorest intelligibility was noted for type II open partial horizontal laryngectomies, followed by chemoradiotherapy. The best intelligibility was found for radiotherapy alone and transoral laser microsurgery. More aggressive surgery as well as chemoradiotherapy correlated with significantly poorer outcomes. Transoral laser microsurgery or radiotherapy alone ensured the best telephonic voice intelligibility. Intermediate-advanced T stages at diagnosis also showed significantly poorer intelligibility outcomes, suggesting that T stage represents an independent negative prognostic factor for voice intelligibility after treatment.
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Affiliation(s)
- Erika Crosetti
- Head and Neck Service, Candiolo Cancer Institute, FPO IRCCS, Candiolo, Italy.
| | - Marco Fantini
- Otorhinolaryngology Service, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Giulia Arrigoni
- Otorhinolaryngology Service, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Laura Salonia
- Otorhinolaryngology Service, Department of Surgery, Città della Salute e della Scienza Hospital, University of Turin, Turin, Italy
| | - Agata Lombardo
- Otorhinolaryngology Service, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Alessio Atzori
- National Institute of Metrological Research, Turin, Italy
| | - Valentina Panetta
- L'altrastatistica srl, Consultancy and Training, Biostatistics office, Rome, Italy
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Andy Bertolin
- Otorhinolaryngology Service, Vittorio Veneto Hospital, Vittorio Veneto, Treviso, Italy
| | - Giuseppe Rizzotto
- Otorhinolaryngology Service, Vittorio Veneto Hospital, Vittorio Veneto, Treviso, Italy
| | - Giovanni Succo
- Otorhinolaryngology Service, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
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The senile functional evolution of the larynx after supracricoid reconstructive surgery. Eur Arch Otorhinolaryngol 2016; 273:4359-4368. [DOI: 10.1007/s00405-016-4177-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 06/24/2016] [Indexed: 10/21/2022]
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Sewnaik A, Hakkesteegt MM, Meeuwis CA, de Gier HHW, Kerrebijn JDF. Supracricoid Partial Laryngectomy with Cricohyoidoepiglottopexy for Recurrent Laryngeal Cancer. Ann Otol Rhinol Laryngol 2016; 115:419-24. [PMID: 16805372 DOI: 10.1177/000348940611500604] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Recurrent laryngeal cancer can be treated either with total laryngectomy or in selected cases with supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP). We performed a retrospective study to analyze the functional and oncological results of supracricoid laryngectomy with CHEP. Methods: Fourteen patients were treated with supracricoid laryngectomy with CHEP. In 8 patients, flexible endoscopic evaluation of swallowing was performed. Preoperative and postoperative voice evaluation was performed in 5 patients. Oncological and functional follow-up, postoperative complications, and data concerning rehabilitation were recorded on standard forms. Results: After the supracricoid laryngectomy with CHEP, 11 of the 14 patients were alive and disease-free. No local recurrences were found, but 2 patients had regional recurrences. The voice was worse after the operation; however, most patients were satisfied. Swallowing was uncompromised. Conclusions: Supracricoid laryngectomy with CHEP for recurrent glottic laryngeal cancer after radiotherapy appears to be oncologically safe and functional.
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Affiliation(s)
- Aniel Sewnaik
- Department of Otolaryngology-Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands
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Akbas Y, Demireller A. Oncologic and functional results of supracricoid partial laryngectomy with cricohyoidopexy. Otolaryngol Head Neck Surg 2016; 132:783-7. [PMID: 15886635 DOI: 10.1016/j.otohns.2005.01.030] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE: Supracricoid partial laryngectomy with cricohyoidopexy (SPL-CHP) is an alternative technique described for extensive tumors of the larynx that are beyond the limits of classical conservation partial laryngectomy and otherwise would be treated by total laryngectomy. STUDY DESIGN AND SETTING: Forty-six patients with carcinoma of the larynx underwent SPL-CHP between 1991 and 2003. The median age was 54 (range, 37 to 72). In 28 cases both arytenoids were spared; in 17 cases, 1 arytenoid was spared; and in 1 case, 2 arytenoids were resected. Bilateral elective neck dissections were performed in supraglottic carcinomas. In glottic carcinomas, neck dissection was performed in the presence of clinically positive lymph nodes. None of the patients were treated with postoperative radiation therapy. RESULTS: Forty-five patients were successfully decannulated; 1 patient with 2 arytenoids resected could not tolerate decannulation. The mean time for decannulation was 20 days (range, 9 to 60 days) when both arytenoids were spared with SPL-CHP, and 41 days (range, 13 to 150 days) for SPL-CHP when 1 arytenoid was spared. The average time for removal of the feeding tube was 21 days (range, 9 to 60 days) when both arytenoids were spared, and 40 days (range, 16 to 127 days) when 1 arytenoid was spared. The removal time of the feeding tube of the patient with 2 arytenoids resected was postoperative day 63. In 2 patients, aspiration pneumonia occurred as a result of swallowing impairment. In none of the patients temporary or permanent gastrostomy was needed. Two patients had local recurrence and were treated with a total laryngectomy; they are still alive. In 2 patients, secondary primary tumors were detected. The 3-year overall and cause-specific actuarial survival rates were 95.7% and 87.5%, respectively. CONCLUSIONS: Although prolonged hospitalization and delaying physiological functions can be termed as disadvantages of SPL-CHP, the operation is a reliable and oncologically valid procedure in selected cases of cancer of the larynx who would otherwise be operated by total laryngectomy.
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Affiliation(s)
- Yucel Akbas
- Department of Otorhinolaryngology, Mersin University School of Medicine, Mersin, Turkey.
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Ozturk K, Akyildiz S, Gode S, Turhal G, Kirazli T, Aysel A, Uluoz U. Post-Surgical and Oncologic Outcomes of Supracricoid Partial Laryngectomy: A Single-Institution Report of Ninety Cases. ORL J Otorhinolaryngol Relat Spec 2016; 78:86-93. [PMID: 26974466 DOI: 10.1159/000444499] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 02/04/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to report the post-surgical and oncologic outcomes of patients who underwent supracricoid partial laryngectomy (SCPL). METHODS 90 patients who underwent SCPL between 1994 and 2014 were reviewed. 45 patients underwent cricohyoidopexy (CHP) and 45 patients cricohyoidoepiglottopexy (CHEP). Median nasogastric (NG) tube removal time, decannulation time, overall survival, disease-free survival and local control rates were calculated. The effect of the type of surgery on functional and oncologic outcomes were assessed. RESULTS Median NG tube removal time was 16.5 days (IQR = 10) and 14 days (IQR = 9) in CHP and CHEP patients, respectively (p > 0.05). Median decannulation time was 30 days (IQR = 26) and 19 days (IQR = 15) in CHP and CHEP patients, respectively (p < 0.05). Resection of one arytenoid significantly increased NG tube removal time. Median follow-up time was 55 months. There were 15 oncologic failures and the median time interval for tumor recurrence was 9 months. Five-year overall survival rate was 80.4%. The 3- and 5-year disease-free specific survival rates were 81.7 and 76.7%, respectively. CONCLUSIONS Given the more extensive surgery applied for CHP, functional outcomes were better in patients with CHEP. Resection of an arytenoid had a negative outcome on swallowing.
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Affiliation(s)
- Kerem Ozturk
- Department of Otolaryngology, Ege University School of Medicine, Izmir, Turkey
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Schindler A, Pizzorni N, Fantini M, Crosetti E, Bertolin A, Rizzotto G, Succo G. Long-term functional results after open partial horizontal laryngectomy type IIa and type IIIa: A comparison study. Head Neck 2015; 38 Suppl 1:E1427-35. [PMID: 26560504 DOI: 10.1002/hed.24254] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The purpose of this study was to compare long-term swallowing, voice results, and quality of life (QOL) after open partial horizontal laryngectomy (OPHL) type IIa and type IIIa. METHODS Twenty-three patients after OPHL type IIa and 18 patients after OPHL type IIIa were involved. Swallowing skills and neoglottis' motility and vibrations were videoendoscopically assessed. Aerodynamic measures, spectrogram analysis, aspiration pneumonia, body weight variations, and voice perceptual assessment were performed. Generic voice-related and swallowing-related QOL were assessed. Data were statistically compared using Mann-Whitney U test or Fisher exact tests, as appropriate. RESULTS Significant differences were found only for the residue with solids and for the intelligibility (I) parameter of the overall quality impression and intelligibility, additive and unnecessary noise, speech fluency, and presence of voiced segments scale with patients of the OPHL type IIIa group showing worse performances than the OPHL type IIa group. CONCLUSION Patients who underwent OPHL type IIa and type IIIa show comparable long-term functional outcomes. OPHL type IIIa represents a valid surgical alternative to OPHL type IIa. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1427-E1435, 2016.
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Affiliation(s)
- Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Nicole Pizzorni
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy
| | - Marco Fantini
- Department of Otorhinolaryngology, Ospedale San Luigi Gonzaga, University of Turin, Italy
| | - Erika Crosetti
- Department of Otorhinolaryngology, Ospedale Martini, Turin, Italy
| | - Andy Bertolin
- Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
| | - Giuseppe Rizzotto
- Department of Otorhinolaryngology, Ospedale Civile of Vittorio Veneto, Belluno, Italy
| | - Giovanni Succo
- Department of Otorhinolaryngology, Ospedale San Luigi Gonzaga, University of Turin, Italy
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Schindler A, Pizzorni N, Mozzanica F, Fantini M, Ginocchio D, Bertolin A, Crosetti E, Succo G. Functional outcomes after supracricoid laryngectomy: what do we not know and what do we need to know? Eur Arch Otorhinolaryngol 2015; 273:3459-3475. [DOI: 10.1007/s00405-015-3822-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 10/29/2015] [Indexed: 10/22/2022]
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Basaran B, Unsaler S, Ulusan M, Aslan I. The Effect of Arytenoidectomy on Functional and Oncologic Results of Supracricoid Partial Laryngectomy. Ann Otol Rhinol Laryngol 2015; 124:788-96. [PMID: 25944594 DOI: 10.1177/0003489415585866] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The effect of arytenoid resection was investigated in patients who had undergone supracricoid partial laryngectomy (SCPL) by comparing functional and oncologic results between patients with both arytenoids preserved with those with one arytenoid resected. METHODS Patients were divided into 2 groups: (1) both arytenoids preserved SCPL (BASCL) cases and (2) one arytenoid preserved SCPL (OASCL). The functional outcomes of the 2 groups were compared in terms of nasogastric tube removal time, decannulation time, incidence of aspiration pneumonia, and Performance Status Scale Scores for Head and Neck Cancer Patients for the late postoperative period. Additionally, the oncologic outcomes of both groups were compared using the 5-year local control rate, overall survival, disease-specific survival, and larynx preservation rate. RESULTS Of the 68 patients who were enrolled in the study, 20 of them were in the OASCL group and 48 in BASCL group. There was no statistically significant difference in the early and late functional outcomes, and the oncologic outcomes were also similar. CONCLUSION In addition to the proven oncologic safety, arytenoid resection does not increase the functional morbidity of the SCPL.
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Affiliation(s)
- Bora Basaran
- Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Selin Unsaler
- Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Murat Ulusan
- Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Ismet Aslan
- Istanbul University Faculty of Medicine, Istanbul, Turkey
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Harada A, Sasaki R, Miyawaki D, Yoshida K, Nishimura H, Ejima Y, Kitajima K, Saito M, Otsuki N, Nibu KI. Treatment outcomes of the patients with early glottic cancer treated with initial radiotherapy and salvaged by conservative surgery. Jpn J Clin Oncol 2014; 45:248-55. [DOI: 10.1093/jjco/hyu203] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mannelli G, Meccariello G, Deganello A, Fiorini FR, Paiar F, Gallo O. Subtotal supracricoid laryngectomy: changing in indications, surgical techniques and use of new surgical devices. Am J Otolaryngol 2014; 35:719-26. [PMID: 25113630 DOI: 10.1016/j.amjoto.2014.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/15/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE The aim of this study is to evaluate the evolution of supracricoid partial laryngectomy (SCPL) in indications, surgical techniques and outcomes through last decades. MATERIALS AND METHODS A retrospective analysis of 146 patients affected by laryngeal cancer treated with SCPL was carried on. We defined: (1) group A, 100 patients treated by cold instruments between 1995 and 2004; (2) group B, 46 patients treated by harmonic scalpel between 2005 and 2010. Complications rate, and functional and oncological results were documented and a comparison between the two groups was made; histopathological analysis of surgical margins was evaluated and correlated with local incidence of recurrence. RESULTS Significant differences in age mean-value (p=0.02), T classification (p=0.007), and in indication for more advanced-staged patients were found in group B (p=0.001). Surgical procedure was shorter in group B (p<0.001), with shorter swallowing recovery (p=0.003). Oncological outcomes did not report any significant differences. Group B showed a higher incidence of post- operative arytenoid edema (p=0.03) associated with a lower rate of pneumonia (p=0.038). Despite a higher rate of close or positive-margins found in group B no higher incidence of local-recurrence was reported (p=0.02) compared to group A. CONCLUSIONS We documented changing in indications and surgical technique for SCPL because of the development of modern diagnostic techniques and the introduction of low-thermal injury device allowing a more challenging tumor excision as well as with a shorter swallowing recovery in our series.
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Affiliation(s)
- Giuditta Mannelli
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, Florence, Italy.
| | - Giuseppe Meccariello
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, Florence, Italy
| | - Alberto Deganello
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, Florence, Italy
| | - Francesca Romana Fiorini
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, Florence, Italy
| | - Fabiola Paiar
- Department of Radiotherapy, University of Florence, Viale G.B. Morgagni, 85, Florence, Italy
| | - Oreste Gallo
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Via Largo Brambilla 3, Florence, Italy
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Qian W, Zhu G, Wang Y, Wang X, Ji Q, Wang Y, Dou S. Multi-modality management for loco-regionally advanced laryngeal and hypopharyngeal cancer: balancing the benefit of efficacy and functional preservation. Med Oncol 2014; 31:178. [DOI: 10.1007/s12032-014-0178-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 08/09/2014] [Indexed: 12/20/2022]
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Schindler A, Fantini M, Pizzorni N, Crosetti E, Mozzanica F, Bertolin A, Ottaviani F, Rizzotto G, Succo G. Swallowing, voice, and quality of life after supratracheal laryngectomy: preliminary long-term results. Head Neck 2014; 37:557-66. [PMID: 24677483 DOI: 10.1002/hed.23636] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 11/14/2013] [Accepted: 02/17/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The purpose of this study was to report preliminary long-term outcomes after supratracheal laryngectomy (STL). METHODS Twenty-two male patients who underwent STL were involved in this study. Swallowing skills, neoglottis motility, and vibrations were videoendoscopically assessed. Aerodynamic measures, spectrogram analysis, aspiration pneumonia, body weight variations, and voice perceptual assessment were performed. Generic, voice-related, and swallowing-related quality of life (QOL) were assessed. RESULTS Aspiration was found in 10, 2, and 5 patients, respectively, for liquids, semisolids, and solids. Neoglottis motility was generally preserved, whereas vibration was impaired. Aerodynamic measures showed a poor performance. Perceptual assessment revealed highly dysphonic voices. In only 8 patients, a harmonic structure was visible in the spectrograms. Aspiration pneumonia occurred in 2 patients. Preoperative weight was maintained in 16 patients. Generic, voice-related, and swallowing-related QOL revealed satisfied patients. CONCLUSION After STL, swallowing was sufficiently restored and QOL was satisfactory, whereas the voice was severely impaired even if oral communication was well preserved.
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Affiliation(s)
- Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco,", University of Milan, Milan, Italy
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Mannelli G, Meccariello G, Deganello A, Maio V, Massi D, Gallo O. Impact of low-thermal-injury devices on margin status in laryngeal cancer. An experimental ex vivo study. Oral Oncol 2013; 50:32-9. [PMID: 24269533 DOI: 10.1016/j.oraloncology.2013.10.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 09/27/2013] [Accepted: 10/03/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Status of margins significantly affects disease-free survival. This study examines in ex vivo model the effect of thermal-injury on margins status comparing traditional instrument with several low-thermal-injury devices. METHODS We conducted a prospective study on 10 excised larynges from patients affected by advanced laryngeal cancer, to assess the thermal-effect due to surgical incisions made at standard distance by using: scalpel, CO2 Laser, harmonic scalpel and electrocautery. Upon histopathological examination, thermal damage (Surgical Artifact, SA), tissue lost/retraction (Shrinkage, S), and tissue alterations were compared for each instrument. RESULTS Low-thermal-injury devices increased SA mean value from 800.7 to 11447.85 μm (72%), and S mean value from 2.226 to 2.910 mm (68.4%) (p<0.05). CONCLUSIONS The choice of surgical device could influence the histopathological margins status, consequently affecting post operative therapeutic strategies and risk of recurrence.
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Affiliation(s)
- Giuditta Mannelli
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Italy.
| | - Giuseppe Meccariello
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Italy
| | - Alberto Deganello
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Italy
| | - Vincenza Maio
- Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Viale G.B. Morgagni, 85, 50134 Florence, Italy
| | - Daniela Massi
- Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Viale G.B. Morgagni, 85, 50134 Florence, Italy
| | - Oreste Gallo
- First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Italy
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Canis M, Ihler F, Martin A, Wolff HA, Matthias C, Steiner W. Results of 226 patients with T3 laryngeal carcinoma after treatment with transoral laser microsurgery. Head Neck 2013; 36:652-9. [PMID: 23596018 DOI: 10.1002/hed.23338] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Revised: 01/09/2013] [Accepted: 04/05/2013] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the feasibility of transoral laser microsurgery (TLM) in treatment of pT3 laryngeal cancer. METHODS We conducted a retrospective case series study of 226 patients with pT3 glottic (n = 122; 54%) or supraglottic laryngeal carcinoma (n = 104; 46%). All patients were treated by TLM in combination with neck dissection (63%) and with postoperative radiotherapy (18%). Our main outcome measures were local control, organ preservation, functional outcome, overall survival, recurrence-free survival, and disease-specific survival. RESULTS Median follow-up period was 57.8 months. The 5-year organ-preservation and local control rates for all patients were 87% and 71.4%, respectively. The 5-year overall, recurrence-free, and disease-specific survival were 64.4%, 63.0%, and 83.3%, respectively. CONCLUSION Results are comparable to partial or total laryngectomy, while being superior to primary chemo(radio)therapy. TLM results in low morbidity, rapid recovery, and good function and can be a valid option for organ-preserving surgery of pT3 glottic and supraglottic cancer.
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Affiliation(s)
- Martin Canis
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Göttingen, Germany
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Supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP) in the management of laryngeal carcinoma: oncologic results. A 35-year experience. Eur Arch Otorhinolaryngol 2012. [DOI: 10.1007/s00405-012-2300-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pinar E, Imre A, Calli C, Oncel S, Katilmis H. Supracricoid partial laryngectomy: analyses of oncologic and functional outcomes. Otolaryngol Head Neck Surg 2012; 147:1093-8. [PMID: 22886078 DOI: 10.1177/0194599812457334] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the functional and oncologic results of supracricoid partial laryngectomy. STUDY DESIGN Case series with chart review. SETTING Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey. SUBJECT AND METHODS The medical records of 56 patients, who underwent supracricoid partial laryngectomy between March 2002 and December 2010, were reviewed in this study. Forty-three patients underwent supracricoid partial laryngectomy with cricohyoidopexy, and 13 patients underwent cricohyoidoepiglottopexy. The overall and disease-specific survival, local control rates, and the mean time of decannulation and nasogastric tube removal were evaluated. Association of type of surgery with the functional and oncologic outcomes was evaluated and statistically compared. RESULTS The median follow-up period was 58 months. The 1-, 3-, and 5-year overall survival rates were 100%, 96.4%, and 82.1%, respectively. The 1-, 3-, and 5-year local control rates were 100%, 96.1%, and 92.5%, respectively. Type of surgery did not show any significant difference in survival and local control rates (P = .546, P = .455). The mean (SD) decannulation and nasogastric feeding tube removal time was 11.43 (2.03) and 16.79 (3.51) days, respectively. The mean time of decannulation and nasogastric tube removal was significantly longer in patients who underwent cricohyoidopexy when compared with those who underwent cricohyoidoepiglottopexy (P = .002, P = .000). CONCLUSION Although delaying deglutition functions could be termed a disadvantage of supracricoid laryngectomy, especially with cricohyoidopexy, supracricoid laryngectomy has reliable oncologic and functional results for locally advanced laryngeal cancers while maintaining laryngeal functions.
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Affiliation(s)
- Ercan Pinar
- Otorhinolaryngology Department, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey
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Thomas L, Drinnan M, Natesh B, Mehanna H, Jones T, Paleri V. Open conservation partial laryngectomy for laryngeal cancer: A systematic review of English language literature. Cancer Treat Rev 2012; 38:203-11. [DOI: 10.1016/j.ctrv.2011.05.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Revised: 05/01/2011] [Accepted: 05/29/2011] [Indexed: 11/25/2022]
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Ambrosch P, Fazel A. Functional organ preservation in laryngeal and hypopharyngeal cancer. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2012; 10:Doc02. [PMID: 22558052 PMCID: PMC3341579 DOI: 10.3205/cto000075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The principles of open versus laser microsurgical approaches for partial resections of the larynx are described, oncologic as well as functional results discussed and corresponding outcomes following primary radiotherapy are opposed. Over the last decade, the endoscopic partial resection of the larynx has developed to an accepted approach in the treatment of early glottic and supraglottic carcinomas thus leading to a remarkable decline in the use of open surgery. Comparing the various surgical approaches of laryngeal partial resections, the oncological outcome of the patients, as far as survival and organ preservation are concerned, are comparable, whereas functional results of the endoscopic procedures are superior with less morbidity. The surgical procedures put together, are all superior to radiotherapy concerning organ preservation. Transoral laser microsurgery has been used successfully for vocal cord carcinomas with impaired mobility or fixation of the vocal cord, supraglottic carcinomas with infiltration of the pre- and/or paraglottic space as well as for selected hypopharyngeal carcinomas. It has been well documented that laser microsurgery achieves good oncological as well as functional results with reasonable morbidity. However, patients with those tumours have been successfully treated by open partial resections of the larynx at medical centres with appropriate expertise. The initially enthusiastic assessment of study results concerning the efficacy of various protocols of chemoradiation with the intent of organ preservation for laryngeal and hypopharyngeal carcinomas are judged more cautious, today, due to recent reports of rather high rates of late toxicity complications.
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Affiliation(s)
- Petra Ambrosch
- Department of Otorhinolaryngology - Head and Neck Surgery, Christian-Albrechts-University of Kiel, Kiel, Germany
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Alicandri-Ciufelli M, Piccinini A, Grammatica A, Chiesi A, Bergamini G, Luppi MP, Nizzoli F, Ghidini A, Tassi S, Presutti L. Voice and swallowing after partial laryngectomy: Factors influencing outcome. Head Neck 2012; 35:214-9. [DOI: 10.1002/hed.22946] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2011] [Indexed: 11/09/2022] Open
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Schindler A, Mozzanica F, Barbiera F. Dysphagia Evaluation and Treatment After Head and Neck Surgery and/or Chemo-radiotherapy for Head and Neck Malignancies. Dysphagia 2012. [DOI: 10.1007/174_2012_606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Topaloğlu I, Bal M, Salturk Z. Supracricoid laryngectomy with cricohyoidopexy: oncological results. Eur Arch Otorhinolaryngol 2011; 269:1959-65. [PMID: 22130913 DOI: 10.1007/s00405-011-1844-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 11/09/2011] [Indexed: 11/25/2022]
Abstract
This study assessed the oncological results in patients undergoing supracricoid laryngectomy with cricohyoidopexy. A cohort of 44 patients surgically treated using supracricoid laryngectomy with cricohyoidopexy between June 2001 and December 2009 was retrospectively analyzed. The mean follow-up period was 53.2 (±24.7) months. The Kaplan-Meier method was used to analyze overall survival and disease-specific survival, as well as survival according to T2 and T3 subgroups. Overall survival rates at 3 and 5 years were 90.5 and 84.1%, respectively. The 3- and 5-year disease-specific survival rates were 95.4 and 92.5%, respectively. Overall survival for patients with T2 disease was 87.5% at 3 years and 80.8% at 5 years. For T3, the corresponding rates were 91.8 and 87.0%. Disease-specific survival for patients with T2 disease was 93.3% at 3 years and the same at 5 years; the corresponding rates for T3 were 96.4 and 91.4%. The differences between T2 and T3 patients at 3 and 5 years with respect to overall and disease-specific survival were not statistically significant (P = 0.903 and P = 0.863, respectively). Recurrence was local in one patient (2.2%) and regional in three (6.8%). There were three distant metastases (6.8%) and one second primary carcinoma (2.2%). These findings support the use of supracricoid laryngectomy with cricohyoidopexy as an oncologically safe technique in properly selected patients with laryngeal carcinoma.
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Affiliation(s)
- Ilhan Topaloğlu
- 1st Ear Nose and Throat Clinic, İstanbul Okmeydanı Training and Research Hospital, İstanbul, Turkey.
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The impact of prelaryngeal node metastases on early glottic cancer treatment results. Eur Arch Otorhinolaryngol 2011; 269:193-9. [DOI: 10.1007/s00405-011-1747-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 08/11/2011] [Indexed: 10/17/2022]
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Castro A, Sanchez-Cuadrado I, Bernaldez R, Del Palacio A, Gavilan J. Laryngeal function preservation following supracricoid partial laryngectomy. Head Neck 2011; 34:162-7. [DOI: 10.1002/hed.21703] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2010] [Indexed: 11/05/2022] Open
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Larynx preservation: what is the standard treatment? Crit Rev Oncol Hematol 2010; 84 Suppl 1:e97-e105. [PMID: 21185198 DOI: 10.1016/j.critrevonc.2010.11.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 11/01/2010] [Accepted: 11/16/2010] [Indexed: 11/20/2022] Open
Abstract
Locally advanced laryngeal and hypo-pharyngeal cancers have a rather poor prognosis. Up until the early 1990s, standard treatment was total laryngectomy, with dramatic functional and social outcome. The introduction of cisplatin based chemotherapy made concurrent chemo-radiotherapy (CCRT) the standard treatment for selected patients, fit for an organ preservation strategy. Over two decades of improvement in nonsurgical management of locally advanced laryngeal cancer is reviewed, including the most recent improvements with the introduction of taxanes and anti-EGFR targeted therapy.
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Rifai M, Hassouna MS, Abdel Fattah AEF, Badran H. Experience with supracricoid laryngectomy variants. Head Neck 2010; 33:1177-83. [PMID: 21755561 DOI: 10.1002/hed.21593] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 02/05/2010] [Accepted: 07/28/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the outcomes after supracricoid laryngectomy (SCL) as an alternative to total laryngectomy (TL) for treatment of laryngeal cancer. METHODS This retrospective study involved 333 patients who underwent 4 types of SCL for squamous cell carcinoma of the larynx in an Egyptian hospital between May 1984 and May 2007. Both functional outcomes and oncological outcomes were evaluated. RESULTS Surgical margins were free from tumor invasion. The overall 5-year survival rate was 74%. Three hundred nine patients (92.8%) were decannulated, whereas 8 patients had permanent stenosis, 6 patients underwent TL, and 10 patients died. Only 7 patients (2.1%) had persistent aspiration; 6 of these patients underwent TL, whereas 1 patient died of pneumonia. The voice intelligibility score ranged from 70% to 100%, with a mean score of 89%. The score was highest when both arytenoids were preserved (mean, 95%). Ten patients died of complications directly related to the surgery. CONCLUSION Supracricoid laryngectomy is effective for managing laryngeal cancer. Modification of the technique to permit resection of both arytenoids is possible in select patients.
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Affiliation(s)
- Mohamed Rifai
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
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