1
|
Senol MC, Bastit V, Humbert M, Babin E, Perréard M. Closure without epiglottoplasty or tracheotomy after reconstructive frontal anterior laryngectomy. Eur Ann Otorhinolaryngol Head Neck Dis 2024:S1879-7296(24)00076-0. [PMID: 38926042 DOI: 10.1016/j.anorl.2024.06.003] [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: 06/28/2024]
Abstract
Reconstructive frontal anterior laryngectomy (RFAL) is a partial laryngeal surgery technique for resecting early-stage (T1-T2) glottic squamous cell carcinoma. Indications comprise a lesion of the anterior commissure of the larynx that cannot be adequately exposed by endoscopy, and cases in which radiotherapy is refused or contraindicated. The initial RFAL technique included epiglottoplasty. Here we propose a technique without epiglottoplasty, with the advantage of avoiding need for tracheotomy in most cases. After the first stage of surgical excision, reconstruction consists in placing a vertical brace transepiglottically and below the cricoid. The epiglottis is thus left at its original height and secured in place to prevent flapping in the pharyngolaryngeal lumen. Transverse bracing is then performed through the thyroid wings: one of the key points of this surgery is to control tension to avoid risk of stenosis. The subhyoid muscles are sutured together to achieve satisfactory sealing. This technique offers satisfying functional results and oncological control. The most frequent complications are (1) secondary tracheotomy, which can be avoided by selecting patients who require a primary tracheotomy and optimizing the seal, and (2) stenosis, which can be limited by not bringing the cartilaginous structures too close together during bracing.
Collapse
Affiliation(s)
- M-C Senol
- Service d'ORL-CCF, CHU de Caen, université de Caen-Normandie, Caen, France
| | - V Bastit
- Service d'ORL-CCF, CHU de Caen, université de Caen-Normandie, Caen, France
| | - M Humbert
- Service d'ORL-CCF, CHU de Caen, université de Caen-Normandie, Caen, France
| | - E Babin
- Service d'ORL-CCF, CHU de Caen, université de Caen-Normandie, Caen, France
| | - M Perréard
- Service d'ORL-CCF, CHU de Caen, université de Caen-Normandie, Caen, France.
| |
Collapse
|
2
|
Hofauer B, Engelmann LS, Chaker A, Heiser C, Straßen U, Wirth M, Wollenberg B. [Laryngeal-preservation surgery in laryngeal cancer]. HNO 2023; 71:193-206. [PMID: 36645433 DOI: 10.1007/s00106-022-01258-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2022] [Indexed: 01/17/2023]
Abstract
After oral cavity and pharyngeal cancer, laryngeal cancer is the third most common malignant tumor in the head and neck region. According to the current German S3 guideline on the diagnosis, treatment, and follow-up of laryngeal cancer, larynx-preserving surgical interventions are part of the standard treatment of this disease, even in advanced tumor stages. However, in order to achieve the desired function-preserving effect, an exact indication is of crucial importance. In this article, the most important larynx-preserving interventions and their indications but also the respective contraindications are presented, with the aim of illuminating the surgical treatment options up to just before total laryngectomy.
Collapse
Affiliation(s)
- Benedikt Hofauer
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland.
| | - Luca-S Engelmann
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Adam Chaker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Clemens Heiser
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Ulrich Straßen
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Markus Wirth
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| | - Barbara Wollenberg
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland
| |
Collapse
|
3
|
Knewitz A, Nanda N, Hoffman MR, Dailey SH, Wieland AM, McCulloch TM. Pre-tracheotomy for Potentially Emergent Airway Scenarios: Indications and Outcomes. Laryngoscope 2021; 131:E2802-E2809. [PMID: 34021601 DOI: 10.1002/lary.29612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/19/2021] [Accepted: 04/28/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS Airway access in the setting of unsuccessful ventilation and intubation typically involves emergent cricothyrotomy or tracheotomy, procedures with associated significant risk. The potential for such emergent scenarios can often be predicted based on patient and disease factors. Planned tracheotomy can be performed in these cases but is not without its own risks. We previously described a technique of pre-tracheotomy or exposing the tracheal framework without entering the trachea, as an alternative to planned tracheostomy in such cases. In this way, a tracheotomy can be easily completed if needed, or the wound can be closed if it is not needed. This procedure has since been used in an array of indications. We describe the clinical situations where pre-tracheotomy was performed as well as subsequent patient outcomes. METHODS Retrospective series of patients undergoing a pre-tracheotomy from 2015 to 2020. Records were reviewed for patient characteristics, indication, whether the procedure was converted to tracheotomy or closed at the bedside, and any post-procedural complications. RESULTS Pre-tracheotomy was performed in 18 patients. Indications included failed extubation after head and neck reconstruction, subglottic stenosis, laryngeal masses, laryngeal edema, thyroid masses, and an oropharyngeal bleed requiring operative intervention. Tracheotomy was avoided in 10 patients with wound closed at the bedside; procedure was converted to tracheotomy in the remaining eight. There were no complications. Indications for conversion included failed extubation, intraoperative hemorrhage, significant stridor with dyspnea, and inability to ventilate. CONCLUSION Pre-tracheotomy offers simplified airway access and provides a valuable option in scenarios where tracheotomy may, but not necessarily, be needed. LEVEL OF EVIDENCE 4 Laryngoscope, 2021.
Collapse
Affiliation(s)
- Allison Knewitz
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A
| | - Nainika Nanda
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A
| | - Matthew R Hoffman
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.,Department of Otolaryngology - Head and Neck Surgery, University of Alabama, Birmingham, Alabama, U.S.A
| | - Seth H Dailey
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A
| | - Aaron M Wieland
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A
| | - Timothy M McCulloch
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A
| |
Collapse
|
4
|
Jung EK, Jin SM, Kim JG, Jung JU, Lee DH, Lee JK, Lim SC, Chung WK, Kim HK, Hwang JE, Shim HJ, Bae WK, Cho SH, Chung IJ, Yoon TM. Comparison of long-term treatment outcomes of T2N0M0 laryngeal squamous cell carcinoma using different treatment methods. Oncol Lett 2020; 20:921-930. [PMID: 32566021 DOI: 10.3892/ol.2020.11628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 04/01/2020] [Indexed: 11/06/2022] Open
Abstract
Early [stage I and II (T2N0M0)] laryngeal cancer types are currently recommended to be treated with a single modality, consisting of definitive radiation therapy or larynx-preserving surgery. Although the treatment outcomes of stage I are good, the frequency of successful outcomes decreases with T2N0M0. Therefore, the present study investigated the treatment outcomes of different treatment methods in T2N0M0 laryngeal cancer. In total, 83 patients with previously untreated T2N0M0 laryngeal squamous cell carcinoma were enrolled. Patients were grouped by treatment method: Radiation therapy (RT; 27 patients); chemoradiotherapy (CRT; 46 patients) with cisplatin base; and surgery-based therapy (SBT; ten patients). The recurrence rates of the RT, CRT and SBT groups were 44.4, 19.6 and 50%, respectively. Moreover, the local control rates of the RT, CRT and SBT groups were 55.6, 87.0 and 80%, respectively. The CRT group had a significantly lower recurrence rate and higher local control rate compared with the RT group (P<0.05). In the survival analysis, overall and disease-specific survival rate did not differ significantly among the treatment groups. However, 3- and 5-year disease-free survival rates (DFS) of the RT group were both 55%, those of the SBT group were both 50% and those of the CRT group were both 80%. Furthermore, the DFS was significantly higher in CRT group compared with the other groups (P=0.02). Using multivariate analysis with Cox regression, it was found that the treatment method was the most important factor for DFS and had a significant impact in the CRT group. In addition, in patients with glottic cancer with anterior commissure and subglottic invasion, the CRT group had significantly improved DFS compared with the RT group, whereas there was no significant difference between the two groups in patients without subglottic invasion. According to National Cancer Institution Common Toxicity Criteria (version 5.0), more patients had toxicity in the CRT group compared with the RT group. However, in the RT and CRT groups, no patients demonstrated mortality due to toxicity, and treatment-related toxicities were manageable. Collectively, although definitive conclusions could not be established, due to the limitations of this retrospective study, the results suggest that CRT had a positive impact on the local control and DFS rates with manageable toxicity in patients with T2N0M0 laryngeal cancer.
Collapse
Affiliation(s)
- Eun Kyung Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Seong-Min Jin
- Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Jae-Gu Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Jae-Uk Jung
- Department of Radiation Oncology, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Dong Hoon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Joon Kyoo Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Sang Chul Lim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Woong-Ki Chung
- Department of Radiation Oncology, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Hee Kyung Kim
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Jun-Eul Hwang
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Hyun-Jeong Shim
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Woo-Kyun Bae
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Sang-Hee Cho
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Ik-Joo Chung
- Department of Internal Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| | - Tae Mi Yoon
- Department of Otorhinolaryngology-Head and Neck Surgery, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeollanam 519-763, Republic of Korea
| |
Collapse
|
5
|
Yang Y, Zhou J, Chen M, Fang Y, Tao L, He P, Cheng L, Wu H. A study of the association between local recurrence and surgical margins in vertical partial laryngectomy for T1 glottic squamous cell carcinoma. Acta Otolaryngol 2019; 139:707-712. [PMID: 31124735 DOI: 10.1080/00016489.2019.1614664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: The effect of surgical margins on local recurrence in T1 glottic squamous cell carcinoma (GSCC) is unclear. Objectives: To investigate the association between surgical margins and local recurrence of T1 GSCC patients with vertical partial laryngectomy (VPL). Materials and methods: We retrospectively studied 117 T1 GSCC patients. Close and negative margins were estimated as distance <5 mm and ≥5 mm. The effect of surgical margins on local recurrence was evaluated. For patients with invasion not reaching muscular-layer, a threshold margin of 2 mm was detected. Results: About 109 patients were exclusively treated by VPL and 8 patients received postoperative radiotherapy. In 109 cases, the posterolateral margins and shortest margins in recurrence group were both lower than no-recurrence group (p<.01). The ratios of posterolateral margin to average diameter, upper-lower diameter and internal-external diameter in recurrence group were also statistically lower (p<.05). A threshold margin of 2 mm showed statistical difference on recurrence in patients with invasion not reaching muscular-layer. Conclusions and significance: Posterolateral margin is crucial for local recurrence in T1 GSCC patients treated by VPL. A shortest margin of ≥5 mm should be considered. For the patients with invasion not reaching the muscular-layer, a threshold of 2 mm is enough for safe margin.
Collapse
Affiliation(s)
- Yue Yang
- Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
- Shanghai Key Clinical Disciplines of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
| | - Jian Zhou
- Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
- Shanghai Key Clinical Disciplines of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
| | - Min Chen
- Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
- Shanghai Key Clinical Disciplines of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
| | - Yi Fang
- Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
- Shanghai Key Clinical Disciplines of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
| | - Lei Tao
- Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
- Shanghai Key Clinical Disciplines of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
| | - Peijie He
- Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
- Shanghai Key Clinical Disciplines of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
| | - Lei Cheng
- Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
- Shanghai Key Clinical Disciplines of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
| | - Haitao Wu
- Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
- Shanghai Key Clinical Disciplines of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, PR China
| |
Collapse
|
6
|
Özkul Y, Ateş D, İmre A, Songu M, Balcı K, Bayrak F, Önal K. Analysis of Recurrence after Frontolateral Laryngectomy. Turk Arch Otorhinolaryngol 2018; 55:27-30. [PMID: 29392048 DOI: 10.5152/tao.2017.2080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 01/14/2017] [Indexed: 11/22/2022] Open
Abstract
Objective This study aimed to evaluate the recurrence and survival of patients treated with frontolateral laryngectomy for T1 and T2 glottic laryngeal carcinoma. Methods Patients who underwent frontolateral laryngectomy for glottic laryngeal carcinoma at a tertiary hospital between March 2009 and June 2014 were included. Patient demographics, tumor stage, treatment and histopathological examination data, and adjuvant therapy details were evaluated. Results Thirty patients with T1aN0, T1bN0, and T2N0 vocal fold carcinoma were examined. The mean follow-up duration was 40 months. Of the 30 patients, nine (30%) were stage T1 and 21 (70%) were in stage T2. Twenty-nine patients were males and one was female, and the mean age was 59 (range, 42-81) years. During follow-up, local recurrence was observed in four patients following frontolateral laryngectomy. Six patients continued smoking after frontolateral laryngectomy, of which three developed tumor recurrence. The local control rate was poor in patients with anterior commissure involvement (66.6%) compared with those with no involvement (95.2%). Two of four patients with local recurrence were treated with salvage total laryngectomy and adjuvant postoperative radiotherapy; the remaining two were treated with only radiotherapy. One patient who was treated with only radiotherapy developed lung metastasis during follow-up and died because of distant metastasis. Conclusion Frontolateral laryngectomy is an efficient choice of treatment for selected cases of T1 and T2 glottic laryngeal carcinoma.
Collapse
Affiliation(s)
- Yılmaz Özkul
- Department of Otorhinolaryngology, Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Düzgün Ateş
- Department of Otorhinolaryngology, Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Abdulkadir İmre
- Department of Otorhinolaryngology, Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Murat Songu
- Department of Otorhinolaryngology, Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Koray Balcı
- Department of Otorhinolaryngology, Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Feda Bayrak
- Department of Otorhinolaryngology, Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| | - Kazım Önal
- Department of Otorhinolaryngology, Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
| |
Collapse
|
7
|
Tamaki A, Miles BA, Lango M, Kowalski L, Zender CA. AHNS Series: Do you know your guidelines? Review of current knowledge on laryngeal cancer. Head Neck 2017; 40:170-181. [PMID: 29076227 DOI: 10.1002/hed.24862] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 05/22/2017] [Indexed: 11/07/2022] Open
Abstract
The following article is part of a series in an initiative by the American Head and Neck Society's Education Committee and will review clinical practice guidelines for head and neck oncology. The primary goal is to increase awareness of current best practices pertaining to head and neck surgery and oncology. This manuscript is a review of current knowledge in laryngeal cancer with a focus on anatomy, epidemiology, diagnosis, evaluation, and treatment.
Collapse
Affiliation(s)
- Akina Tamaki
- Ear, Nose, and Throat Institute, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - Brett A Miles
- Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai Medical Center, New York, New York
| | - Miriam Lango
- Department of Surgical Oncology, Division of Head and Neck Surgery, Fox Chase Cancer Center, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Luiz Kowalski
- Head and Neck Surgery and Otorhinolaryngology Department, A C Camargo Cancer Center, Sao Paulo, Brazil
| | - Chad A Zender
- Ear, Nose, and Throat Institute, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| |
Collapse
|
8
|
Asada Y, Kurosawa K, Matsumoto K, Goto T, Katoh K, Imai T, Saijo S, Matsuura K. Laryngeal function-preserving operation for T4a laryngeal cancer with vocal cord paralysis - A case report. Auris Nasus Larynx 2017; 45:194-199. [PMID: 28416345 DOI: 10.1016/j.anl.2017.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 01/18/2017] [Accepted: 03/10/2017] [Indexed: 11/27/2022]
Abstract
For locally advanced laryngeal cancers, the standard treatment of choice is chemoradiotherapy if organ function needs to be conserved. Surgical treatment with larynx preservation is conducted only for limited cases. For locally advanced laryngeal cancers such as those with vocal cord fixation and/or cricoid cartilage destruction, there is no apparent standardized organ-preserving surgery keeping the essential laryngeal functions, viz. the airway, deglutition and articulation, uncompromized. Recently, our surgical team saw a patient with T4a advanced laryngeal cancer with vocal cord fixation who aspired to maintain his laryngeal function. Driven by his eagerness, we contrived novel techniques for laryngeal function preservation and performed a two-staged operation. In the first stage, extended vertical partial laryngectomy was conducted including resection of the affected thyroid, arytenoid, and cricoid cartilages, followed by local closure of the hypopharynx. Additionally, laryngeal suspension surgery and cricopharyngeal myotomy were performed in addition to suturing the epiglottis with the intact arytenoid cartilage to enhance swallowing function. In the second stage, airway reconstruction was performed using a local skin flap. As of 10 months after operation, there has been no tumor recurrence, and the reconstructed larynx has been working satisfactorily. In this report we describe an innovative operation that was especially contrived for laryngeal function preservation.
Collapse
Affiliation(s)
- Yukinori Asada
- Department of Head and Neck Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan.
| | - Koreyuki Kurosawa
- Department of Plastic and Reconstructive Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Ko Matsumoto
- Department of Diagnostic Radiology, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Takahiro Goto
- Department of Plastic and Reconstructive Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Kengo Katoh
- Department of Otorhinolaryngology, Head and Neck Surgery, Tohoku University School of Medicine, Miyagi Japan
| | - Takayuki Imai
- Department of Head and Neck Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Shigeru Saijo
- Department of Head and Neck Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan
| | - Kazuto Matsuura
- Department of Head and Neck Surgery, Miyagi Cancer Center, Natori, Miyagi, Japan
| |
Collapse
|
9
|
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.
Collapse
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
| |
Collapse
|
10
|
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.
Collapse
Affiliation(s)
- Susanne Wiegand
- Department of Otolaryngology, Head & Neck Surgery, University Hospital of Leipzig, Germany
| |
Collapse
|
11
|
Day AT, Sinha P, Nussenbaum B, Kallogjeri D, Haughey BH. Management of primary T1-T4 glottic squamous cell carcinoma by transoral laser microsurgery. Laryngoscope 2016; 127:597-604. [PMID: 27578610 DOI: 10.1002/lary.26207] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Revised: 06/15/2016] [Accepted: 06/27/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVES/HYPOTHESIS Evaluate the oncologic outcomes of patients with early and select advanced primary glottic squamous cell carcinoma (SCCa) managed by transoral laser microsurgery (TLM). STUDY DESIGN Retrospective cohort study. METHODS Ninety cases of TLM-managed primary glottic SCCa were identified retrospectively using a prospectively collected database. RESULTS Outcomes of patients with pTis-pT2a disease (n = 65) and pT2b-pT4a disease (n = 25) were, respectively: 5-year local control, 86.2% and 67.5%; 5-year disease-free survival, 64.9% and 44.9%; 5-year disease-specific survival, 96.4% and 59.0%; laryngeal preservation, 96.9% and 80%. Five of nine patients (56%) with supraglottic-glottic-subglottic tumors were local recurrence-free compared to the 70 of 81 (86%) patients with glottic, supraglottic-glottic, and glottic-subglottic tumors. Seven of 13 patients (54%) with positive or indeterminate margins were local recurrence-free compared to 68 of 77 (88%) patients with negative margins. CONCLUSIONS Given sample size considerations, this study highlights the satisfactory oncologic outcomes of TLM-treated glottic cancer and the potential importance of margin management and disease extension within the larynx. LEVEL OF EVIDENCE 4 Laryngoscope, 127:597-604, 2017.
Collapse
Affiliation(s)
- Andrew T Day
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Parul Sinha
- Department of Otolaryngology-Head and Neck Surgery, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, U.S.A
| | - Brian Nussenbaum
- Department of Otolaryngology-Head and Neck Surgery, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, U.S.A
| | - Dorina Kallogjeri
- Department of Otolaryngology-Head and Neck Surgery, Washington University in Saint Louis School of Medicine, Saint Louis, Missouri, U.S.A
| | - Bruce H Haughey
- Department of Head and Neck Surgery, Florida Hospital Celebration Health, Celebration, Florida, U.S.A.,Department of Surgery, University of Auckland, Auckland, New Zealand
| |
Collapse
|
12
|
Graciano AJ, Sonagli M, da Silva AGC, Fischer CA, Chone CT. Partial laryngectomy in glottic cancer: complications and oncological results. Braz J Otorhinolaryngol 2016; 82:275-80. [PMID: 26614047 PMCID: PMC9444659 DOI: 10.1016/j.bjorl.2015.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 05/05/2015] [Indexed: 11/10/2022] Open
Abstract
Introduction Most patients with laryngeal carcinoma present tumors in the glottis that can be treated by different treatment modalities. Some authors consider open partial laryngectomy as obsolete, while others still deem this as a viable and cost-efficient option. Objectives To compare the oncological and functional results of a series of patients undergoing partial laryngectomy vs. external radiotherapy for the treatment of glottic cancer. Methods Historical cohort study with a series of glottic carcinoma patients undergoing partial laryngectomy or external radiotherapy during a period of ten years. Results Sixty-two patients with glottic carcinoma were included. Group A comprised those submitted to partial laryngectomy (n = 30), and Group B, those who underwent radiotherapy (n = 32). They were homogeneous in the comparison of mean age, 56.4 vs. 60.4 years (p = 0.12) and distribution in pathological stage (p = 0.91). With regard to oncological outcome, there were no differences in distant metastasis rates, or second primary tumor between groups (p = 1.0), as well as in disease-free time, laryngeal rescue-free time, and overall five-year survival. Severe complication rates were also similar between groups. Conclusion Open partial laryngectomy had complication rates and oncological results similar to those of radiotherapy for patients with glottic carcinomas and should still be considered among the main available therapeutic options.
Collapse
|
13
|
Britt CJ, Rohrbach MR, McCulloch TM. Tracheal exposure: Anticipatory management of the difficult airway. Head Neck 2016; 38:E2446-E2448. [DOI: 10.1002/hed.24419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2015] [Indexed: 11/09/2022] Open
Affiliation(s)
- Christopher J. Britt
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery; University of Wisconsin School of Medicine and Public Health; Madison Wisconsin
| | - Marc R. Rohrbach
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery; University of Wisconsin School of Medicine and Public Health; Madison Wisconsin
| | - Timothy M. McCulloch
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery; University of Wisconsin School of Medicine and Public Health; Madison Wisconsin
| |
Collapse
|
14
|
Hartl DM, Brasnu DF. Contemporary Surgical Management of Early Glottic Cancer. Otolaryngol Clin North Am 2015; 48:611-25. [DOI: 10.1016/j.otc.2015.04.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
15
|
Kardasz-Ziomek M, Ścierski W, Namysłowski G. [Operation treatment results of laryngeal cancer in different types of partial laryngectomy based on own material]. Otolaryngol Pol 2014; 68:233-8. [PMID: 25283319 DOI: 10.1016/j.otpol.2013.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 11/19/2013] [Accepted: 11/27/2013] [Indexed: 11/17/2022]
Abstract
THE AIM of the study was to evaluate the oncological results of laryngeal cancer treatment performed in the Laryngology University Ward in Zabrze in the years 1990-2000, depending on the type of partial surgery applied. MATERIALS AND METHODS Retrospective clinical material includes 209 patients in whom surgery was a primary treatment method. No distant metastases (M1) or another malignant cancer were found. In all 209 patients the squamous cell carcinoma of various degree of malignancy (G1-G3) was found. The most common operation in the analyzed group was a chordectomy - 83 surgeries (40%), next, vertical partial laryngectomies - 38 (18%), horizontal glottis surgeries - 28 (13%). In 79 patients (38%) partial laryngectomy was complemented with a nodal operation. The median of the observation period was 9 years. Local recurrence, nodal recurrence and distant metastasis are rated as treatment failure. Treatment effectiveness was evaluated with relation to overall survival, disease-free survival, cause specific survival and local control. All the above-mentioned parameters were analyzed with the updated percentages method. The level of statistical significance was assumed to be p≤0.05. RESULTS The best oncological results were observed after vertical operations. In the vertical operations group the most favourable oncological results were noted after chordectomy. 83% overall survivals, 82% disease-free survivals, 93% cause specific survivals and 96% local controls in the 5-year observation. On the other hand, the least favourable treatment results were observed after ¾ subtotal partial operation, after horizontal supraglottic operation and after reconstruction operation with CHP. Statistically significant differences in treatment results between the groups of patients after various types of partial operations were found in relation to local controls and disease-free survivals.
Collapse
Affiliation(s)
- Małgorzata Kardasz-Ziomek
- Katedra i Oddział Kliniczny Laryngologii w Zabrzu Śląskiego Uniwersytetu Medycznego w Katowicach, Kierownik: prof. dr hab. med. Grzegorz Namysłowski, Zabrze, Poland.
| | - Wojciech Ścierski
- Katedra i Oddział Kliniczny Laryngologii w Zabrzu Śląskiego Uniwersytetu Medycznego w Katowicach, Kierownik: prof. dr hab. med. Grzegorz Namysłowski, Zabrze, Poland
| | - Grzegorz Namysłowski
- Katedra i Oddział Kliniczny Laryngologii w Zabrzu Śląskiego Uniwersytetu Medycznego w Katowicach, Kierownik: prof. dr hab. med. Grzegorz Namysłowski, Zabrze, Poland
| |
Collapse
|
16
|
Canis M, Ihler F, Martin A, Matthias C, Steiner W. Transoral laser microsurgery for T1a glottic cancer: Review of 404 cases. Head Neck 2014; 37:889-95. [DOI: 10.1002/hed.23688] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 01/02/2014] [Accepted: 03/08/2014] [Indexed: 11/09/2022] Open
Affiliation(s)
- Martin Canis
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Göttingen; Göttingen Germany
| | - Friedrich Ihler
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Göttingen; Göttingen Germany
| | - Alexios Martin
- Department of Audiology and Phoniatrics; University of Berlin; Berlin Germany
| | - Christoph Matthias
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Göttingen; Göttingen Germany
| | - Wolfgang Steiner
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Göttingen; Göttingen Germany
| |
Collapse
|
17
|
Xu H, Dong P, Sun Z, Xie J. An empirical study of modified frontolateral partial laryngectomy without tracheotomy. Exp Ther Med 2013; 5:523-526. [PMID: 23407890 PMCID: PMC3570194 DOI: 10.3892/etm.2012.838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 11/23/2012] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to validate the feasibility of modified frontolateral partial laryngectomy without tracheotomy using animal experiments. The glottic area before and after surgery of 6 excised canine larynges and 10 canine larynges in vivo were compared to observe whether the glottic area following modified frontolateral partial laryngectomy without tracheotomy is adequate for breathing. Significant differences were observed between the glottic areas of the excised larynges in the initial state and following modified frontolateral partial laryngectomy with the cartilage closed. However, no significant differences were observed between the glottic areas of the excised larynx in the initial state and following modified frontolateral partial laryngectomy with the cartilage open. The glottic area of the larynges in vivo in the initial state and following right chordectomy via laryngofissure were not observed to be significantly different. Furthermore, no significant differences were observed between the glottic areas of the larynges in vivo in the initial state and following modified frontolateral partial laryngectomy without tracheotomy. In conclusion, modified frontolateral partial laryngectomy without tracheotomy is a feasible and efficacious means of eradicating early and selected invasive carcinomas of the larynx, which is supported by animal experiments.
Collapse
Affiliation(s)
- Hongming Xu
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Jiao Tong University Medical College, Affiliated Shanghai First People's Hospital; Shanghai, P.R. China
| | | | | | | |
Collapse
|
18
|
Goessler UR. Traditional transcutaneous approaches in head and neck surgery. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2012; 11:Doc06. [PMID: 23320058 PMCID: PMC3544212 DOI: 10.3205/cto000088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The treatment of laryngeal and hypopharyngeal malignancies remains a challenging task for the head and neck surgeon as the chosen treatment modality often has to bridge the gap between oncologically sound radicality and preservation of function. Due to the increase in transoral laser surgery in early tumor stages and chemoradiation in advanced stages, the usage of traditional transcutaneous approaches has decreased over the recent past. In addition, the need for a function-sparing surgical approach as well as highest possible quality of life has become evident. In view of these facts, rationale and importance of traditional transcutaneous approaches to the treatment of laryngeal and hypopharyngeal malignancies are discussed in a contemporary background. The transcutaneous open partial laryngectomies remain a valuable tool in the surgeon's armamentarium for the treatment of early and advanced laryngeal carcinomas, especially in cases of impossible laryngeal overview using the rigid laryngoscope. Open partial laryngetomies offer superior overview and oncologic safety at the anterior commissure, especially in recurrencies. In select advanced cases and salvage settings, the supracricoid laryngectomy offers a valuable tool for function-preserving but oncologically safe surgical therapy at the cost of high postoperative morbidity and a very demanding rehabilitation of swallowing.In hypopharyngeal malignancies, the increasing use of transoral laser surgery has led to a decline in transcutaneous resections via partial pharyngectomy with partial laryngectomy in early tumor stages. In advanced stages of tumors of the piriform sinus and the postcricoid area with involvement of the larynx, total laryngectomy with partial pharyngectomy is an oncologically safe approach. The radical surgical approach using circumferent laryngopharyngectomy with/without esophagectomy is indicated in salvage cases with advanced recurrences or as a primary surgical approach in patients where chemoradiation does not offer sufficient oncologic control or preservation of function. In cases with impending reconstruction, fasciocutaneous free flaps (anterolateral thigh flap, radial forearm flap) seem to offer superior results to enteric flaps in cases where the cervical esophagus is not involved leading to better voice rehabilitation with fewer complications and postoperative morbidity. In salvage situations, the Gastroomental Free Flap has proven to be a valuable tool.In conclusion, the choice of a surgical treatment modality is influenced by the patient's anatomy, tumor size and location as well as the surgeon's personal expertise.
Collapse
|
19
|
Lassig AAD, Yueh B, Joseph AM. The effect of smoking on perioperative complications in head and neck oncologic surgery. Laryngoscope 2012; 122:1800-8. [PMID: 22753048 DOI: 10.1002/lary.23308] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 02/01/2012] [Accepted: 02/23/2012] [Indexed: 11/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS Cigarette smoking is the most important risk factor for head and neck cancer. Conventional wisdom suggests that smoking causes increased postoperative wound healing and systemic complications in this patient population, but it is unclear if the clinical literature supports this. STUDY DESIGN Systematic review. METHODS The authors performed a review of the literature from 1990 to 2010 on the effect of cigarette smoking on perioperative complications in head and neck surgery. RESULTS Thirty-six articles met eligibility criteria and were reviewed; 14 focused on extirpative surgery and 22 on reconstruction. Most of the evidence was comprised of case series and small cohort studies. We reviewed local wound healing and systemic complications, and 47% of studies supported an association between smoking and complications of surgery. CONCLUSIONS Evidence from the existing clinical literature is inconclusive on an association between cigarette smoking and perioperative complications after head and neck surgery. The negative impact of smoking is suggested; however, the majority of articles had significant methodological weaknesses. Prospective study of tobacco-induced complications is needed.
Collapse
Affiliation(s)
- Amy Anne D Lassig
- Department of Otolaryngology-Head and Neck Surgery, Division of General Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
| | | | | |
Collapse
|
20
|
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]
|
21
|
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.
Collapse
Affiliation(s)
- Petra Ambrosch
- Department of Otorhinolaryngology - Head and Neck Surgery, Christian-Albrechts-University of Kiel, Kiel, Germany
| | | |
Collapse
|
22
|
Rodrigo JP, Coca-Pelaz A, Suárez C. The Current Role of Partial Surgery As a Strategy for Functional Preservation in Laryngeal Carcinoma. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2011. [DOI: 10.1016/j.otoeng.2010.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
23
|
Mantsopoulos K, Psychogios G, Koch M, Zenk J, Waldfahrer F, Iro H. Comparison of different surgical approaches in T2 glottic cancer. Head Neck 2011; 34:73-7. [PMID: 21374754 DOI: 10.1002/hed.21687] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2010] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate retrospectively the oncologic results of endoscopic and open surgical techniques in treating T2 glottic carcinomas. METHODS The medical chart of 354 patients with T2 glottic cancer managed with primary surgery were reviewed. Laser microsurgery and frontolateral partial laryngectomy were compared for disease-specific survival and local control rates, incidence of major complications, and related tracheostomies. Additionally, the influence of the anterior commissure invasion on these oncologic parameters was evaluated. RESULTS No statistically significant differences were found between the surgical procedures regarding our oncologic parameters. A lower incidence of tracheotomies and complications were comparatively found for laser surgery. Tumor invasion of the anterior commissure did not seem to influence the oncologic results. CONCLUSION Transoral surgery seems to be the treatment of choice for T2 glottic cancer. In our view, open partial laryngectomy should be reserved for those cases in which the lesion cannot be adequately exposed by direct microlaryngoscopy.
Collapse
Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen - Nuremberg Medical School, Germany
| | | | | | | | | | | |
Collapse
|
24
|
Liu XK, Zhang Q, Li Q, Liu WW, Li H, Zeng ZY, Guo ZM. Laryngeal framework reconstruction using titanium mesh in glottic cancer after frontolateral vertical partial laryngectomy. Laryngoscope 2011; 120:2197-202. [PMID: 20824791 DOI: 10.1002/lary.21103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To investigate the feasibility and efficacy of laryngeal framework reconstruction using titanium mesh in patients with glottic cancer after frontolateral vertical partial laryngectomy. STUDY DESIGN Prospective study. METHODS Defect of laryngeal framework, caused by frontolateral vertical partial laryngectomy in nine patients with T2 or T3 squamous cell carcinoma of glottic, were reconstructed with titanium mesh from 2007 to 2009. Computed tomography (CT) and fiberscopic examinations were performed at two weeks and three months postoperatively. RESULTS No aspiration and laryngeal stenosis was observed in the nine patients. CT scanning showed that titanium mesh was fastened well without displacement and deformity and that there was no laryngeal stenosis. Fiberscopic inspection showed that the larynx lumen was maintained well without stricture, shrinkage, and necrosis. No titanium mesh was exposed to the larynx lumen. CONCLUSIONS Titanium mesh was a good alternative for reconstruction of the laryngeal framework. It provided adequate structural support to maintain airway patency.
Collapse
Affiliation(s)
- Xue-Kui Liu
- State Key Laboratory of Oncology in South China, Department of Head and Neck Surgery, Cancer Center, Sun Yat-Sen University, Guangzhou, Guangdong, P.R. China
| | | | | | | | | | | | | |
Collapse
|
25
|
Hartl DM, Ferlito A, Brasnu DF, Langendijk JA, Rinaldo A, Silver CE, Wolf GT. Evidence-based review of treatment options for patients with glottic cancer. Head Neck 2011; 33:1638-48. [PMID: 21990228 DOI: 10.1002/hed.21528] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2010] [Indexed: 11/08/2022] Open
Affiliation(s)
- Dana M Hartl
- Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France.
| | | | | | | | | | | | | |
Collapse
|
26
|
Wang CJ, Knecht R. Current concepts of organ preservation in head and neck cancer. Eur Arch Otorhinolaryngol 2010; 268:481-7. [PMID: 21107854 DOI: 10.1007/s00405-010-1407-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 10/08/2010] [Indexed: 11/24/2022]
Abstract
The treatment of laryngeal and hypopharyngeal cancer nowadays is not limited by surgical resection. There are many interdisciplinary approaches which we can offer these patients in our clinics. These include radiotherapy, chemotherapy, biologicals and surgery. The combination of radiotherapy, chemotherapy, biologicals and surgery techniques more and more allows us to perform organ and function preservation in a former often mutilating and function destroying treatment. Since the early 1990s, evidence from large randomized trials has shown that organ preservation studies using sequential and concomitant radio-chemotherapy do not compromise survival when compared with surgery followed by radiotherapy. However, using these therapies side effects have to be taken into consideration and not organ preservation but function preservation is the treatment goal. The current most common treatment options are shown here in this review. For future treatment protocols there is an urgent need to refine the definition of a functional organ, to define quality of life endpoints and to refine the recommendations for evaluating treatment response.
Collapse
Affiliation(s)
- C-J Wang
- Department of Head and Neck Surgery and Otolaryngology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | | |
Collapse
|
27
|
Rodrigo JP, Coca-Pelaz A, Suárez C. [The current role of partial surgery as a strategy for functional preservation in laryngeal carcinoma]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010; 62:231-8. [PMID: 20684940 DOI: 10.1016/j.otorri.2010.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 06/07/2010] [Indexed: 11/26/2022]
Abstract
With the current advances and recent organ preservation protocols for intermediate or advanced stage laryngeal cancer, based on chemotherapy, the role of surgery seemed replaced except for surgical rescue of tumours not responding to these treatments, total laryngectomy being the surgical option. This type of non-surgical treatment is offered as a strategy for organ preservation, as opposed to total laryngectomy. However, we believe that there are two organ-preservation strategies, surgical and non-surgical. A wide spectrum of surgical techniques is available and such techniques lead to excellent results, both oncological and functional (speech and swallowing). The aim of this paper is to present options for organ-preserving surgery for laryngeal cancer. A review of surgical techniques available for functional preservation in cancer of the larynx at intermediate or advanced stage is presented. In addition to classic approaches such as vertical partial laryngectomy and horizontal or supraglottic laryngectomy, options for conservative laryngeal surgery have improved significantly over the past two decades. Minimally invasive surgery, transoral laser surgery, and supracricoid partial laryngectomy have become important laryngeal preservation approaches for patients with laryngeal cancer. Surgery must define its role in the multidisciplinary treatment of advanced cancers of the larynx, which at present often favours (chemo)radiotherapy protocols.
Collapse
Affiliation(s)
- Juan Pablo Rodrigo
- Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias, Principado de Asturias, España
| | | | | |
Collapse
|
28
|
Pradhan S, Mehta M, Hakeem A, Tubachi J, Kannan R. Transoral resection of laryngeal and hypopharyngeal cancers. Indian J Surg Oncol 2010; 1:207-11. [PMID: 22930636 PMCID: PMC3421007 DOI: 10.1007/s13193-010-0034-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Accepted: 04/30/2010] [Indexed: 11/26/2022] Open
Abstract
The advent of transoral microlaryngoscopic laser surgery is making a significant impact on treatment decisions in the management of early squamous cancers of the larynx and the hypopharynx. It has, to a great extent replaced the conventional open partial laryngectomy procedures. Moreover many cancers of the larynx or the hypopharynx that were earlier being treated with radiation therapy are now resected transorally with the CO(2) laser. This article focuses on the progress of transoral laser microsurgery in the management of early larygopharyngeal cancers.
Collapse
Affiliation(s)
- Sultan Pradhan
- Department of Surgical Oncology, Prince Aly Khan Hospital, Aga Hall, Mazgaon, Mumbai, 400 010 India
| | - Marzi Mehta
- Department of Surgical Oncology, Prince Aly Khan Hospital, Aga Hall, Mazgaon, Mumbai, 400 010 India
| | - Arsheed Hakeem
- Department of Surgical Oncology, Prince Aly Khan Hospital, Aga Hall, Mazgaon, Mumbai, 400 010 India
| | - Jagadish Tubachi
- Department of Surgical Oncology, Prince Aly Khan Hospital, Aga Hall, Mazgaon, Mumbai, 400 010 India
| | - R. Kannan
- Department of Surgical Oncology, Prince Aly Khan Hospital, Aga Hall, Mazgaon, Mumbai, 400 010 India
| |
Collapse
|
29
|
Dispenza F, Saraniti C, Mathur N, Dispenza C. Modified fronto-lateral laryngectomy in treatment of glottic T1(a-b) cancer with anterior commissure involvement. Auris Nasus Larynx 2009; 37:469-73. [PMID: 20031352 DOI: 10.1016/j.anl.2009.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Revised: 11/04/2009] [Accepted: 11/19/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Evaluation of clinical and oncological safety of the modified fronto-lateral laryngectomy in the treatment of T1a-b glottic cancer. METHODS Retrospective review of charts of patients managed with classical fronto-lateral laryngectomy or with our modified technique using a cervical fascia flap and a false cord flap to reconstruct the defect. RESULTS No recurrence of cancer was observed in the present series and slight dysphonia was present in all cases. The patients managed with classical technique required a revision surgery for granulations or anterior synechia in 4 cases; those managed with modified technique did not need a second intervention. CONCLUSION The fronto-lateral laryngectomy should be present in the head-neck surgeon armamentarium. In T1a-b glottic cancer this technique gives a good oncological resection, but the postoperative period requires an intensive rehabilitation process. The modification of the classical technique reduces the incidence of a second intervention.
Collapse
Affiliation(s)
- Francesco Dispenza
- Dipartimento Discipline Chirurgiche e Oncologiche UO Otorinolaringoiatria, Università degli Studi di Palermo, Palermo, Italy.
| | | | | | | |
Collapse
|
30
|
Dedivitis RA, Andrade-Sobrinho JD, Castro MAFD. Fatores prognósticos e impacto da comorbidade na laringectomia fronto-lateral. Rev Col Bras Cir 2009; 36:392-7. [DOI: 10.1590/s0100-69912009000500006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Accepted: 03/02/2009] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar sobrevida, impacto da comorbidade, complicações e fatores de falha da laringectomia como tratamento de tumores malignos glóticos. MÉTODOS: Foram analisadas 38 pacientes com tumor glótico sob estadiamento clínico T1b/T2N0M0 submetidos à laringectomia fronto-lateral com reconstrução, de janeiro de 1995 a dezembro de 2006. Foram avaliados os resultados oncológicos, comorbidades (através da escala Adult Comorbidity Evaluation - 27 ACE-27) e complicações, sendo correlacionados com dados demográficos e características do tumor. RESULTADOS: Oito pacientes apresentaram recidiva local e foram resgatados cirurgicamente. Complicações não foram verificadas em 33 pacientes. Não houve diferença significativa das sobrevidas global em cinco anos e livre de doença ao considerarem-se as diferentes categorias de comorbidades. Somente o envolvimento patológico das margens mostrou diferenças significativas na sobrevida global (p=0,0033) e sobrevida livre de doença (p<0,0001). CONCLUSÃO: A sobrevida global em cinco anos foi de 67,6% e a sobrevida livre de doença de 73,7%; a comorbidade não representou fator prognóstico independente; o índice de complicações pós-operatórias foi de 13,2% e somente o envolvimento patológico das margens mostrou diferenças significativas na sobrevida global e livre de doença.
Collapse
|
31
|
Dong P, Li X, Xie J, Li L, Xu H. Modified frontolateral partial laryngectomy without tracheotomy. Otolaryngol Head Neck Surg 2009; 141:70-4. [PMID: 19559961 DOI: 10.1016/j.otohns.2009.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2008] [Revised: 02/03/2009] [Accepted: 02/03/2009] [Indexed: 11/18/2022]
Abstract
Objective: To investigate the feasibility of modified frontolateral partial laryngectomy without tracheotomy for patients with early-stage laryngeal cancer or dysplasia of the true vocal cord. Study Design: After frontolateral partial laryngectomy, the inner side of the sternohyoid muscle was drawn into the laryngeal lumen to suture it to the incisal margin of the uninjured side and to the false vocal cord on the side of the lesion to ensure the safety without tracheotomy. A reverted sternohyoid fascial flap was used to cover the anterior area to form a new laryngeal lumen in the shape of a ladder. Subjects and Methods: A total of 65 patients with early glottic carcinomas or severe dysplasia of the true vocal cord were treated with modified frontolateral partial laryngectomy without tracheotomy. Ipsilateral false vocal cord flaps and cervical skin flaps were used in 63 patients and two patients respectively to reconstruct the defect. Results: Deglutition and phonation were fully recovered after 7 to 10 days postsurgery. The only postoperative complication was subcutaneous emphysema noted in nine patients. The 1-, 3-, and 5-year survival rates were all 100 percent. Conclusion: Modified frontolateral partial laryngectomy without tracheostomy is an effective surgical method for early glottic carcinomas and severe dysplasia of the true vocal cord.
Collapse
Affiliation(s)
- Pin Dong
- Department of Otolaryngology-Head and Neck Surgery, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
| | | | | | | | | |
Collapse
|
32
|
Chawla S, Carney AS. Organ preservation surgery for laryngeal cancer. HEAD & NECK ONCOLOGY 2009; 1:12. [PMID: 19442314 PMCID: PMC2686690 DOI: 10.1186/1758-3284-1-12] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Accepted: 05/15/2009] [Indexed: 11/04/2022]
Abstract
The principles of management of the laryngeal cancer have evolved over the recent past with emphasis on organ preservation. These developments have paralleled technological advancements as well as refinement in the surgical technique. The surgeons are able to maintain physiological functions of larynx namely speech, respiration and swallowing without compromising the loco-regional control of cancer in comparison to the more radical treatment modalities. A large number of organ preservation surgeries are available to the surgeon; however, careful assessment of the stage of the cancer and selection of the patient is paramount to a successful outcome. A comprehensive review of various organ preservation techniques in vogue for the management of laryngeal cancer is presented.
Collapse
Affiliation(s)
- Sharad Chawla
- Department of Otolaryngology, Head and Neck Surgery, Flinders Medical Centre, South Australia, Australia
| | - Andrew Simon Carney
- Department of Otolaryngology, Head and Neck Surgery, Flinders Medical Centre, South Australia, Australia
| |
Collapse
|
33
|
Ganly I, Patel SG, Matsuo J, Singh B, Kraus DH, Boyle J, Wong R, Shaha AR, Shah JP. Analysis of postoperative complications of open partial laryngectomy. Head Neck 2009; 31:338-45. [PMID: 19073010 DOI: 10.1002/hed.20975] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Ian Ganly
- Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Singh A, Kazi R, De Cordova J, Nutting C, Clarke P, Harrington K, RhysEvans P. Multidimensional Assessment of Voice After Vertical Partial Laryngectomy: A Comparison With Normal and Total Laryngectomy Voice. J Voice 2008; 22:740-5. [DOI: 10.1016/j.jvoice.2007.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2006] [Accepted: 04/16/2007] [Indexed: 11/28/2022]
|
35
|
The Utility of Second-Look Operation After Laser Microresection of Glottic Carcinoma Involving the Anterior Commissure. Laryngoscope 2008; 118:1400-4. [DOI: 10.1097/mlg.0b013e318175338f] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
36
|
Ferreiro-Argüelles C, Jiménez-Juan L, Martínez-Salazar JM, Cervera-Rodilla JL, Martínez-Pérez MM, Cubero-Carralero J, González-Cabestreros S, López-Pino MA, Fernández-Gallardo JM. CT Findings after Laryngectomy. Radiographics 2008; 28:869-82; quiz 914. [DOI: 10.1148/rg.283075091] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
37
|
Smith RB. Surgery in the Management of Laryngeal and Hypopharyngeal Carcinoma. Int J Radiat Oncol Biol Phys 2007; 69:S28-30. [PMID: 17848287 DOI: 10.1016/j.ijrobp.2007.03.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2007] [Accepted: 03/25/2007] [Indexed: 11/30/2022]
Affiliation(s)
- Russell B Smith
- Department of Otolaryngology, University of Iowa, Iowa City, IA 52242, USA.
| |
Collapse
|
38
|
Akimoto T, Nonaka T, Kitamoto Y, Ishikawa H, Ninomiya H, Chikamatsu K, Furuya N, Hayakawa K, Mitsuhashi N, Nakano T. Radiation therapy for T2N0 laryngeal cancer: A retrospective analysis for the impact of concurrent chemotherapy on local control. Int J Radiat Oncol Biol Phys 2006; 64:995-1001. [PMID: 16406396 DOI: 10.1016/j.ijrobp.2005.10.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2005] [Revised: 10/09/2005] [Accepted: 10/11/2005] [Indexed: 11/29/2022]
Abstract
PURPOSE The impact of concurrent chemotherapy on the local control in patients with T2N0 laryngeal cancer who receive radiation therapy (RT) was evaluated. METHODS AND MATERIALS Sixty-three patients with T2N0 laryngeal cancer who were treated by definitive RT were analyzed. The primary site of the cancer was the glottis in 50 patients, the supraglottis in 9 patients, and the subglottis in 4 patients. Thirty-six patients were treated by RT alone and the remaining 27 patients received concurrent chemoradiotherapy (CRT). RESULTS Complete response (CR) was obtained in 92% of the patients who received RT alone and 100% of the patients who received CRT. Voice preservation in the group who received CRT (89%) was significantly higher than that in the group treated by RT alone (61%). The 5-year disease-free survival rates in those who received concurrent CRT was significantly superior to that in the patients who received RT alone, although no significant difference was seen in the cause-specific survival rate between the 2 groups. The multivariate analysis revealed that the treatment method (RT alone vs. CRT) was the most significant risk factor that predicted recurrence after RT. CONCLUSION Concurrent CRT had a positive impact on the local control of T2N0 laryngeal cancer.
Collapse
Affiliation(s)
- Tetsuo Akimoto
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Moore BA, Holsinger FC, Diaz EM, Weber RS. Organ-Preservation Laryngeal Surgery in the Era of Chemoradiation. Curr Probl Cancer 2005; 29:169-79. [PMID: 16143165 DOI: 10.1016/j.currproblcancer.2005.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Brian A Moore
- Tulane University School of Medicine, and Keesler Air Force Base, Biloxi, MS, USA
| | | | | | | |
Collapse
|