1
|
Bertolin A, Lionello M, Ghizzo M, Cena I, Leone F, Valerini S, Mattioli F, Crosetti E, Presutti L, Succo G, Rizzotto G. Salvage open partial horizontal laryngectomy after failed radiotherapy: A multicentric study. Laryngoscope 2019; 130:431-436. [PMID: 31046149 DOI: 10.1002/lary.27959] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/01/2019] [Accepted: 03/11/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The primary aim of the present study was to report our multi-institutional experience in surgical salvage with open partial horizontal laryngectomies (OPHL) after failed radiotherapy (RT) for laryngeal squamous cell carcinoma (LSCC). Secondary aims were to analyze the prognostic meaning of the main clinical and pathological parameters in relation to the oncologic outcome and to compare our results with the available literature. STUDY DESIGN A retrospective multicenter analysis of surgical oncological outcomes. METHODS We retrospectively review the clinical charts of 70 recurrent LSCC patients after primary RT failure undergone salvage OPHL. RESULTS At last follow-up, 46 patients (65%) were disease-free; six (9%) were alive with disease; nine (12%) died because of the disease; and nine (12%) died without evidence of disease. The final local control, overall survival, disease-specific survival, and laryngectomy-free survival were 87%, 75%, 87%, and 91%, respectively. Twelve patients (17%) experienced postoperative complications, whereas 18 patients (25%) experienced late sequelae. In five patients (7%), decannulation was not possible because of postoperative laryngeal stenosis. CONCLUSION In selected patients, when proper selection criteria for conservation laryngeal surgery are adopted, OPHL can be considered for salvage after RT failure. LEVEL OF EVIDENCE 4 Laryngoscope, 130:431-436, 2020.
Collapse
Affiliation(s)
- Andy Bertolin
- Otorhinolaryngology Service, Vittorio Veneto Hospital, Treviso, Italy
| | - Marco Lionello
- Otorhinolaryngology Service, Vittorio Veneto Hospital, Treviso, Italy
| | - Marco Ghizzo
- Otorhinolaryngology Service, Vittorio Veneto Hospital, Treviso, Italy
| | - Isida Cena
- Otorhinolaryngology Service, Vittorio Veneto Hospital, Treviso, Italy
| | | | - Sara Valerini
- Department of Otolaryngology-Head and Neck Surgery, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Francesco Mattioli
- Department of Otolaryngology-Head and Neck Surgery, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Erika Crosetti
- Head Neck Oncology Unit Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy
| | - Livio Presutti
- Department of Otolaryngology-Head and Neck Surgery, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Giovanni Succo
- Head Neck Oncology Unit Candiolo Cancer Institute-FPO IRCCS, Candiolo, Italy.,Department of Oncology, University of Turin, Orbassano, Italy
| | - Giuseppe Rizzotto
- Otorhinolaryngology Service, Vittorio Veneto Hospital, Treviso, Italy
| |
Collapse
|
2
|
Maurizi M, Almadori G, Plaudetti G, De Corso E, Galli J. Laser carbon dioxide cordectomy versus open surgery in the treatment of glottic carcinoma: Our results. Otolaryngol Head Neck Surg 2016; 132:857-61. [PMID: 15944555 DOI: 10.1016/j.otohns.2005.01.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE: To analyze oncologic results in patients with glottic cancers treated respectively, by laser CO2 or open surgery, taking into account specific-disease survival, rate of locoregional recurrences, and their salvageability. STUDY DESIGN: Retrospective study of 198 patients treated from January 1993 to June 2002 in the department of otorhinolaryngology at a Catholic university in Rome. METHODS: Glottic carcinoma were treated by laser CO2 cordectomy in 132 patients (group 1) and by open surgery in 66 patients (group 2). The statistical analysis was performed by Kaplan Meyer method, log rank test, and x 2 , test. RESULTS: The log-rank test points out significant differences between the 2 groups regarding specific-disease survival; no differences were found for disease-free survival. Within group 1, 16 patients developed local failure, which was retreated in 6 cases with laser surgery; in 9 (6.8%) with total laryngectomy, only 1 case was inoperable. In this group, 10 patients (62.5%) were salvaged. Within group 2, 18 patients developed local recurrences, which was retreated in 14 (21.21%) cases with total laryngectomy; the other 4 cases were not suitable for surgery. Of these 18, 8 patients (44.5%) were salvaged. CONCLUSIONS AND SIGNIFICANCE: Our results show significant differences between the 2 groups concerning the specific-disease survival and the salvageability of local recurrences. In fact, in group 1 we found a higher salvage rate and a lower incidence of total laryngectomy. As already suggested, laser therapy leaves the laryngeal cartilaginous framework intact, avoiding the spread of the tumor out of laryngeal organ and resulting in a more favorable oncologic outcome.
Collapse
Affiliation(s)
- Maurizio Maurizi
- Institute of Otorhinolaryngology, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | | | | |
Collapse
|
3
|
Vilaseca I, Blanch JL, Berenguer J, Grau JJ, Verger E, Muxí Á, Bernal-Sprekelsen M. Transoral laser microsurgery for locally advanced (T3-T4a) supraglottic squamous cell carcinoma: Sixteen years of experience. Head Neck 2016; 38:1050-7. [DOI: 10.1002/hed.24408] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2015] [Indexed: 01/01/2023] Open
Affiliation(s)
- Isabel Vilaseca
- Department of ORL-HNS; Hospital Clínic; Barcelona Spain
- ENT Surgical Oncology Section; Hospital Clínic; Barcelona Spain
- University of Barcelona Medical School; Barcelona Spain
| | - José Luis Blanch
- Department of ORL-HNS; Hospital Clínic; Barcelona Spain
- ENT Surgical Oncology Section; Hospital Clínic; Barcelona Spain
| | - Joan Berenguer
- Neuroradiology Section, Department of Radiology; Hospital Clínic; Barcelona Spain
| | - Juan José Grau
- Department of Medical Oncology; Hospital Clínic; Barcelona Spain
- University of Barcelona Medical School; Barcelona Spain
| | - Eugenia Verger
- Department of Radiation Oncology; Hospital Clínic; Barcelona Spain
| | - África Muxí
- Department of Nuclear Medicine; Hospital Clínic; Barcelona Spain
| | - Manuel Bernal-Sprekelsen
- Department of ORL-HNS; Hospital Clínic; Barcelona Spain
- University of Barcelona Medical School; Barcelona Spain
| |
Collapse
|
4
|
Fasunla AJ, Ogundoyin OA, Onakoya PA, Nwaorgu OG. Malignant tumors of the larynx: Clinicopathologic profile and implication for late disease presentation. Niger Med J 2016; 57:280-285. [PMID: 27833247 PMCID: PMC5036299 DOI: 10.4103/0300-1652.190596] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Malignant laryngeal tumors are uncommon. Late presentation of the disease may worsen management outcomes. We described the epidemiologic, clinicopathologic profile, and management outcomes of laryngeal tumors in a tertiary health institution in Nigeria. Materials and Methods: An 11-year retrospective review of medical records of patients managed for malignant laryngeal tumor at the University College Hospital, Ibadan, Nigeria, was performed. Results: There were 97 patients comprising 74 (76.3%) males and 23 (23.7%) females with a mean age of 60.48 ± 12.15 years. The mean duration of illness was 7.3 ± 3.8 months. History of cigarette smoking and alcohol consumption was in 2.1% and 14.4% patients, respectively. The most common clinical presentations were hoarseness, cough, and dyspnea. Transglottis (91.8%) was the most common anatomic tumor location and 92.8% patients presented in advanced disease stage. Four histologic types were identified with squamous cell carcinoma accounting for 96.9%. About 92% patients had emergency tracheostomy and 56 (57.7%) patients had total laryngectomy. The postoperative complications were pharyngocutaneous fistula (5.2%) and peristomal recurrence (3.1%). The 5-year survival rate was 52.5%. Conclusions: Malignant laryngeal tumors are uncommon, but more females are getting the disease. Squamous cell carcinoma is the most common histologic variant. Late stage disease presentation and initial wrong diagnosis contributed to the poor management outcome.
Collapse
Affiliation(s)
- Ayotunde James Fasunla
- Department of Otorhinolaryngology, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Oluwole Agboola Ogundoyin
- Department of Otorhinolaryngology, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Paul Adekunle Onakoya
- Department of Otorhinolaryngology, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| | - Onyekwere George Nwaorgu
- Department of Otorhinolaryngology, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria
| |
Collapse
|
5
|
Cömert E, Tunçel Ü, Dizman A, Yükselen Güney Y. Comparison of Early Oncological Results of Diode Laser Surgery with Radiotherapy for Early Glottic Carcinoma. Otolaryngol Head Neck Surg 2014; 150:818-23. [DOI: 10.1177/0194599814521775] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective To evaluate the oncologic results of transoral endolaryngeal microscopic diode laser surgery (MDLS) and radiotherapy (RT) for T1 and T2 glottic carcinoma. Study Design Case series with planned chart review. Setting Ankara Oncology Education and Research Hospital. Subjects and Methods The study was conducted on a series of 140 cases of early glottic carcinoma (T1, T2) treated with MDLS or RT. The tumors were defined according to T stage and the involvement of the anterior commissure (AC). Results The 3-year locoregional control rate of MDLS and RT groups was 93.1% and 89.7%, respectively ( P = .434). There was no difference in 3-year disease-free survival when comparing T1 and T2 tumors treated with MDLS and those treated with RT ( P = .618 for T1, P = .084 for T2). There was no difference in disease-free survival when comparing AC– and AC+ tumors treated with MDLS and those treated with RT ( P = .291 for AC– and P = .530 for AC+ tumors). Conclusions Microscopic diode laser surgery in early glottic cancer seems to be an oncologically safe procedure that has similar oncological results with RT. In T2 glottic tumors and AC involvement, the results with either treatment are less satisfactory.
Collapse
Affiliation(s)
- Ela Cömert
- Ankara Oncology Education and Research Hospital, Clinic of Otolaryngology, Ankara, Turkey
| | - Ümit Tunçel
- Ankara Oncology Education and Research Hospital, Clinic of Otolaryngology, Ankara, Turkey
| | - Ayşen Dizman
- Ankara Oncology Education and Research Hospital, Clinic of Radiation Oncology, Ankara, Turkey
| | - Yıldız Yükselen Güney
- Ankara Oncology Education and Research Hospital, Clinic of Radiation Oncology, Ankara, Turkey
| |
Collapse
|
6
|
Rutkowski T, Wygoda A, Składowski K, Hejduk B, Rutkowski R, Lukaszczyk-Widel B, Hutnik M, Maciejewski B. Predictors of radiotherapy outcome in patients with T2 supraglottic carcinoma. Eur Arch Otorhinolaryngol 2011; 269:923-9. [PMID: 22116382 DOI: 10.1007/s00405-011-1847-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Accepted: 11/09/2011] [Indexed: 11/27/2022]
Abstract
The decision regarding treatment of early supraglottic carcinoma remains controversial. Single institution clinical data of patients with T2 supraglottic carcinoma treated exclusively with radiotherapy in terms of prognostic factors and treatment results were analyzed. Patient-related factors that would potentially by useful for optimal therapeutic decision to be undertaken were especially investigated. Between 1994 and 2004, 78 patients with T2 supraglottic carcinoma underwent radiotherapy (RT) in Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Poland. There were 54 (69%) males and 24 (31%) females in the median age of 61 years. There were 17 (22%) patients with N+. Median body mass of patients before (BM0) and after RT (BM1) was 74 kg (range 45.2-130 kg) and 72.9 kg (range 49.9-122.5 kg), respectively. Median hemoglobin concentrations before (Hb0) and after (Hb1) RT were 14.3 and 13.4 g/dl, respectively. Median change of Hb concentration during RT (dHb) was -0.8 g/dl. All were treated up to total doses (TD) ranged from 62.5 to 72 Gy. The overall treatment time (OTT) ranged from 30 to 70 days. Estimates of local control (LC), ultimate local control (uLC), and overall survival (OS) were calculated using the Kaplan-Meier method. Log rank statistics, Cox proportional hazard model and step-wise Cox regression hazard model were employed to identify prognostic factors for LC, uLC, and OS in univariate and multivariate analyses. The 5-year LC, RC, uLC and OS rates were 85, 92, 88, and 56%, respectively. In multivariate analysis N+ (p = 0.01) and prolonged OTT (p = 0.03) significantly decreased LC. Females (p = 0.02), higher BM0 (p = 0.03), and HB0 (p = 0.006) significantly prolonged OS. Patient-related factors like gender, hemoglobin concentration, and body mass may predict treatment outcome. Radiotherapy is effective for T2 supraglottic carcinoma of the larynx unless higher dose intensity is provided. Involved regional lymph nodes significantly deteriorate locoregional cure.
Collapse
Affiliation(s)
- Tomasz Rutkowski
- Department of Radiation Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, ul. Wybrzeże Armii Krajowej 15, 44-100, Gliwice, Poland.
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Peretti G, Piazza C, Ansarin M, De Benedetto L, Cocco D, Cattaneo A, Nicolai P, Chiesa F. Transoral CO2 laser microsurgery for Tis-T3 supraglottic squamous cell carcinomas. Eur Arch Otorhinolaryngol 2010; 267:1735-42. [DOI: 10.1007/s00405-010-1284-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2009] [Accepted: 05/07/2010] [Indexed: 10/19/2022]
|
8
|
Wein RO, Weber RS. The current role of vertical partial laryngectomy and open supraglottic laryngectomy. Curr Probl Cancer 2006; 29:201-14. [PMID: 16143168 DOI: 10.1016/j.currproblcancer.2005.06.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Richard O Wein
- Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, MS, USA
| | | |
Collapse
|
9
|
Abstract
PURPOSE The aim of this paper is to present results of analysis of 102 females with laryngeal cancer. MATERIALS AND METHODS Between 1974 and 1995, 102 female patients with cancer of larynx were treated at Radiotherapy Department of Oncology Centre in Kraków. Twenty-six of them had positive familial oncological history. The treatment method depended on stage of disease. Primary radical irradiation was performed in 66 patients, 29 patients received postoperative radiotherapy after surgery (total or partial laryngectomy), seven patients received induction chemotherapy followed by laryngectomy with postoperative radiotherapy or radical irradiation. The median dose applied with radiotherapy was 60 Gy, and dose per fraction was 2 Gy. RESULTS The actuarial 5-year rates were as follows: 88.9% for overall survival, 84.2% for disease-free survival, and 85.4% for local control. Only tumour stage and nodal involvement were found to be significant factor for all three endpoints. We found that younger patients had more supraglottic primary localisation, and these patients frequently were non-smoker. CONCLUSIONS The tumour stage and nodal involvement were found to be significant prognostic factors in analysed group of female treated with laryngeal cancer.
Collapse
Affiliation(s)
- B Sas-Korczynska
- Department of Radiation Oncology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, ul. Garncarska 11, 31-115 Cracow, Poland
| | | | | |
Collapse
|
10
|
Grau C, Johansen LV, Hansen HS, Andersen E, Godballe C, Andersen LJ, Hald J, Møller H, Overgaard M, Bastholt L, Greisen O, Harbo G, Hansen O, Overgaard J. Salvage laryngectomy and pharyngocutaneous fistulae after primary radiotherapy for head and neck cancer: a national survey from DAHANCA. Head Neck 2003; 25:711-6. [PMID: 12953306 DOI: 10.1002/hed.10237] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE In 1998, the Danish Society for Head and Neck Oncology decided to conduct a nationwide survey at the five head and neck oncology centers with the aim of evaluating the surgical outcome of salvage laryngectomy after radiotherapy with special emphasis on identifying factors that could contribute to the development of pharyngocutaneous fistulae. PATIENTS A total of 472 consecutive patients undergoing postirradiation salvage laryngectomy in the period July 1, 1987-June 30, 1997 were recorded at the five head and neck oncology centers in Denmark. Age ranged from 36 to 84 years, median 63 years, 405 men and 67 women. Primary tumor site was glottic larynx (n = 242), supraglottic larynx (n = 149), other larynx (n = 45), pharynx (n = 27), and other (n = 9). All patients had received prior radiotherapy. RESULTS Median time between radiotherapy and laryngectomy was 10 months (range, 1-348 months). A total of 89 fistulae lasting at least 2 weeks were observed, corresponding to an overall average fistulae risk of 19%. The number of performed laryngectomies per year decreased linearly (from 58 to 37), whereas the annual number of fistulae increased slightly (from 7 to 11), which meant that the corresponding estimated fistulae risk increased significantly from 12% in 1987 to 30% in 1997. Other significant risk factors for fistulae in univariate analysis included younger patient age, primary advanced T and N stage, nonglottic primary site, resection of hyoid bone, high total radiation dose, and large radiation fields. Multiple logistic regression analysis of these parameters suggested that nonglottic tumor site, late laryngectomy period (1987-1992 vs 1993-1997), and advanced initial T stage were independent prognostic factors for fistulae risk. Surgical parameters like resection of thyroid/tongue base/trachea or radiotherapy parameters like overall treatment time or fractions per week did not influence fistulae risk. CONCLUSIONS The risk of fistulae is especially high in patients initially treated with radiotherapy for nonglottic advanced stage tumors. A significant decrease in the number of performed salvage laryngectomies over the 10 years was seen. Over the same time period, the annual number of fistulae remained almost constant. The resulting more than doubling of fistulae rate could thus in part be explained by less surgical routine.
Collapse
Affiliation(s)
- Cai Grau
- Department of Oncology, Aarhus University Hospital, 8000 Aarhus C, Denmark.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Yiotakis J, Stavroulaki P, Nikolopoulos T, Manolopoulos L, Kandiloros D, Ferekidis E, Adamopoulos G. Partial laryngectomy after irradiation failure. Otolaryngol Head Neck Surg 2003; 128:200-9. [PMID: 12601315 DOI: 10.1067/mhn.2003.63] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Radiation therapy is often the first method of treating patients with early cancer of the glottis. There is a substantial failure rate among these patients. Total laryngectomy has usually been the means of treating patients with failure after radiation. In recent decades, partial laryngectomy has been used for salvage in such patients. This article will discuss the use of partial laryngectomy for radiation failure both from the oncologic result as well as the morbidity. PATIENTS AND METHODS Between 1984 and 1995, 27 patients with early-stage laryngeal carcinoma underwent salvage partial laryngectomy after irradiation failure. Vertical laryngectomy was performed in 18 patients (13 with T1 N0 and 5 with T2 N0) and horizontal-supraglottic laryngectomy in 9 patients (3 with T1 N0, 1 with T2 N0, and 5 with T2 N1). The mean follow-up was 4.1 years. RESULTS Local control was obtained in 77.7% of patients with glottic lesions (T1: 84.6%; T2: 60%, P = NS) and in 55.5% of patients with supraglottic lesions (T1: 66.6%; T2: 50%; P = NS). There was no regional recurrence in the vertical laryngectomy group, whereas the regional control rate in the horizontal-supraglottic laryngectomy group was 77.7%. Distant control was achieved in 94.4% of patients with glottic disease and in 77.7% of patients with supraglottic disease. The overall survival rate for glottic lesions was 88.8% (T1: 92.3%; T2: 80%; P = NS) versus 66.6% for supraglottic lesions (T1: 100%; T2: 50%; P = NS). CONCLUSION AND SIGNIFICANCE Vertical laryngectomy was not associated with an increased complication rate. Morbidity in the horizontal-supraglottic laryngectomy group was higher, but a satisfactory functional outcome was obtained in all cases. Therefore, in early laryngeal cancer (glottic T1-T2, supraglottic T1) partial laryngectomy can be performed with good expectation of cure and satisfactory laryngeal function. In T2 supraglottic lesions, the oncologic results are less satisfactory; further research is required for developing more efficient complimentary or alternative treatments modalities.
Collapse
Affiliation(s)
- John Yiotakis
- Ear, Nose and Throat Department, Faculty of Medicine, University of Athens
| | | | | | | | | | | | | |
Collapse
|
12
|
Johansen LV, Grau C, Overgaard J. Glottic carcinoma--patterns of failure and salvage treatment after curative radiotherapy in 861 consecutive patients. Radiother Oncol 2002; 63:257-67. [PMID: 12142089 DOI: 10.1016/s0167-8140(02)00118-4] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE The aim of this study was to evaluate the patterns of failure and the treatment of recurrences, in a series of primary irradiated patients with squamous cell carcinoma of the glottic larynx. MATERIALS AND METHODS Eight hundred and sixty-one consecutive patients were included in this study from 1963 to 1991, out of which 74 were females and 787 males. The stages were: I 56, II 26, III 15, and IV 3%. In 847 of 861 cases (98%) the primary treatment was delivered with curative intent, and out of these 834 patients received primary radical radiotherapy. RESULTS With a minimum follow up of 5 years, 274/861(32%) patients had persistent or recurrent disease; in 91% of these the persistent or recurrent disease was in the T-position, 15% in the N-position, and 5% developed distant metastases. Curative salvage attempt was possible in 207 patients, and 145 were subsequently controlled. A total of 718 (83%) patients obtained ultimate tumour control, 584 (68%) without a laryngectomy (134 of the controlled had a laryngectomy, 109 had a total laryngectomy and 25 had a partial laryngectomy). In the patients treated with curative intent, the overall 5-year local tumour control, loco-regional tumour control, disease specific survival rate and overall survival rate was 72, 70, 86 and 66%, respectively. For patients with small tumours the disease specific survival for T1a, T1b and T2 was 95, 93 and 83%, respectively. In the 718 patients cured for their glottic carcinoma, 204 new primary malignant tumours were detected. CONCLUSIONS The study shows that laryngeal glottic carcinoma can be effectively managed by primary radiotherapy and surgery salvage. The control is obtained with a high proportion of laryngeal preservation (68%). Recurrences treated with surgical salvage have a success rate of 70%. New primaries are a major problem.
Collapse
Affiliation(s)
- Lars Vendelbo Johansen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, DK-8000 Aarhus C, Denmark
| | | | | |
Collapse
|
13
|
The status of partial salvage laryngeal surgery following definitive primary radiotherapy. Curr Opin Otolaryngol Head Neck Surg 2000. [DOI: 10.1097/00020840-200004000-00006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|