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Campo F, Mazzola F, Bianchi G, Manciocco V, Ralli M, Greco A, Sperduti I, de Vincentiis M, Pellini R. Partial laryngectomy for naïve pT3N0 laryngeal cancer: Systematic review on oncological outcomes. Head Neck 2023; 45:243-250. [PMID: 36177857 DOI: 10.1002/hed.27205] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/26/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022] Open
Abstract
The first aim was to define the oncologic outcomes of open partial laryngectomy (OPL) in naïve pT3 laryngeal cancer. The second aim was to analyze the outcomes after OPL versus total laryngectomy (TL). A literature search was conducted in three databases (MEDLINE, EMBASE, and Cochrane Library) until January 2022. In 805 patients treated with OPL, 5-year OS, DSS, DFS and LFS were 80.5% (95% CI 70.6-87.6), 83.4% (95% CI 75.7-89), 77.4% (95% CI 66.3-85.7) and 77.9% (95% CI 68.7-85), respectively. Three articles compared TL versus OLP: 5-year OS, DSS and DFS risk difference were 0.100 (95% CI -0.092 to 0.291), 0.067 (95% CI -0.085 to 0.220) and 0.018 (95% CI -0.164 to 0.201) respectively. OPL for selected pT3 laryngeal cancer is able to guarantee a high percentage of oncological success. Accurate patient selection is of utmost importance to differentiate advanced disease amenable to conservative surgery.
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Affiliation(s)
- Flaminia Campo
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
- Department of "Organi di Senso", Sapienza University of Rome, Rome, Italy
| | - Francesco Mazzola
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Giulia Bianchi
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Valentina Manciocco
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
| | - Massimo Ralli
- Department of "Organi di Senso", Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of "Organi di Senso", Sapienza University of Rome, Rome, Italy
| | - Isabella Sperduti
- Biostatistical Unit, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | | | - Raul Pellini
- Department of Otolaryngology-Head and Neck Surgery, Regina Elena National Cancer Institute IRCCS, Rome, Italy
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de Vincentiis M, Greco A, Campo F, Candelori F, Ralli M, Di Traglia M, Colizza A, Cambria F, Zocchi J, Manciocco V, Spriano G, Pellini R. Open partial horizontal laryngectomy for T2-T3-T4a laryngeal cancer: oncological outcomes and prognostic factors of two Italian hospitals. Eur Arch Otorhinolaryngol 2022; 279:2997-3004. [PMID: 34978589 DOI: 10.1007/s00405-021-07238-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/22/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE The purpose of this study was to analyse the oncologic results of open partial horizontal laryngectomy (OPHL) and to assess the prognostic factors that could affect the survival of patients affected by T2, T3 and T4a laryngeal cancer. Using this data, we aim to identify clinical criteria to select patients amenable to conservative surgery, and to facilitate a more targeted approach in the management of advanced laryngeal cancer. METHODS A retrospective study was performed in patients who underwent OPHL type II for laryngeal squamous cell carcinoma from January 2005 to December 2018. We analysed a total of 170 patients; 21(12.36%) cases were staged as pT2, 116 (68.23%) as pT3 and 33 (19.41%) as pT4a. RESULTS Five-year overall survival (OS) was 80.9%, 79.3%, 70.4% for T2, T3 and T4 respectively. Disease-specific survival (DSS) was 90.4%, 85.3% and 77.4%. Posterior tumour extension, perineural invasion and N status showed to considerably influence survival in both uni- and multivariate analyses. CONCLUSION The oncological outcomes from our study show that OPHL for advanced laryngeal cancer can guarantee a high percentage of success. Accurate patient selection is of utmost importance to differentiate advanced disease amenable to conservative surgery, and treatment options should consider selected criteria based on tumour and patient features.
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Affiliation(s)
- Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Flaminia Campo
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy.,Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francesca Candelori
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Mario Di Traglia
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - Andrea Colizza
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy.
| | - Francesca Cambria
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00186, Rome, Italy
| | - Jacopo Zocchi
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Valentina Manciocco
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giuseppe Spriano
- Otorhinolaryngology Unit, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
| | - Raul Pellini
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Abstract
State-of-the-art MR imaging of the larynx and hypopharynx with high-resolution surface coils, parallel imaging techniques, and DWI has several advantages over CT for assessing submucosal tumor spread, in particular neoplastic involvement of the paraglottic space, laryngeal cartilages, and extralaryngeal soft tissues. Current diagnostic MR imaging criteria based on a combination of distinct imaging features on morphologic sequences combined with DWI allow improved discrimination between tumor, peritumoral inflammation, and fibrosis and, ultimately, an increased precision for submucosal tumor delineation, which is a key prerequisite for tailored treatment options. Multiparametric MR imaging with DWI has a higher diagnostic performance than CT.
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Affiliation(s)
- Minerva Becker
- Diagnostic Department, Division of Radiology, Unit of Head and Neck and Maxillo-facial Radiology, Geneva University Hospitals, University of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneva 14, Geneva 1211, Switzerland.
| | - Yann Monnier
- Department of Clinical Neurosciences, Clinic of Otorhinolaryngology, Head and Neck Surgery, Unit of Cervicofacial Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva 14, Geneva 1211, Switzerland
| | - Claudio de Vito
- Diagnostic Department, Division of Clinical Pathology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva 14, Geneva 1211, Switzerland
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Abstract
AIM This study was to present long-term oncological results, as well as the variables, that can increase nodal metastasis and reduce survival in patients diagnosed in the early and late stages of laryngeal cancer. METHODS A total of 85 patients were included in the study. These patients were grouped as supracricoid partial laryngectomy (PL), supraglottic horizontal PL, and vertical frontolateral PL. Furthermore, at least 3 years of the long-term outcomes of the patients in these 3 groups were compared. RESULTS Twenty-two of the patients (26%) had nodal metastasis, 16 (72%) of these patients were in Group I (P = 0.017); 14 patients (51%) had preepiglottic space (P = 0.075); 12 patients (50%) had paraglottic space involvement (P = 0.002); 9 (45%) patients with nodal metastasis had a depth of invasion more than 20 mm (P < 0.001). Out of the 16 patients who had positive intraoperative surgery margins, 5 (18%) of them had nodal metastasis (P = 0.589) and 14 (16%) patients were positive for perineural invasion, 3 (19%) of these patients had lymph node involvement (P = 0.074). One (5%) patient died with nodal metastasis. Median survival rate of all the patients was 44 ± 0.836 (42.36-45.63) months and the overall survival rate was 92.9%. CONCLUSIONS Paraglottic space involvement and tumor invasion depth were statistically effective on increased nodal metastasis. However, we suggest that depth of invasion may not be effective alone as a prognostic factor. In contrast to the known effect on overall survival was less lymph node.
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