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Garcia D, Laccourreye O. Suicide after total laryngectomy for cancer in France. Eur Ann Otorhinolaryngol Head Neck Dis 2024:S1879-7296(24)00056-5. [PMID: 38702263 DOI: 10.1016/j.anorl.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Affiliation(s)
- D Garcia
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, université Paris Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - O Laccourreye
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, HEGP, université Paris Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
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Laccourreye O, Garcia D, Haroun F, Nguyen DH, Giraud P, Mirghani H. Primary Total Laryngectomy for Endolaryngeal cT3-4M0 Squamous Cell Carcinoma: A STROBE Analysis. Laryngoscope 2024; 134:2288-2294. [PMID: 37921374 DOI: 10.1002/lary.31129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/21/2023] [Accepted: 10/04/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVES To document 10-year oncologic outcome of primary total laryngectomy (TL) for patients with cT3-4M0 endolaryngeal squamous cell carcinoma (SCC). STUDY DESIGN Observational inception cohort of 531 patients with isolated untreated endolaryngeal cT3-4M0 SCC review over 40 years using STROBE guideline. 94% of patients were followed until death or for a minimum of 10 years. SETTING Academic tertiary referral care center. METHODS All patients underwent primary TL. Prior tracheotomy, induction chemotherapy, thyroid gland resection, level II-IV neck dissection, level VI dissection, and postoperative radiation therapy were associated in 6%, 40%, 43%, 89%, 47%, and 74% of cases, respectively: The main objective was to determine the 10-year actuarial local control estimate. Accessory objectives comprised screening for clinical variables increasing the risk of local recurrence, and analysis of long-term oncologic consequences of local recurrence. RESULTS The 10-year actuarial local control estimate was 89.7%. Local recurrence was salvaged in 11% of cases, resulting in 92% overall local control. On multivariate analysis, none of the study variables correlated with local recurrence. Local recurrence resulted in significantly reduced nodal control, distant metastasis control, and survival. Postoperative complications, persistent index SCC, intercurrent disease, and metachronous second primary cancer accounted for respectively 3%, 37%, 33%, and 28% of the 334 deaths noted during the 10 years following TL. CONCLUSION The present study underscored the long-term oncologic efficacy of primary TL, the dangers of local recurrence, the key role of local control for survival, and the importance of a long-term oncologic watch policy. LEVEL OF EVIDENCE 3 Laryngoscope, 134:2288-2294, 2024.
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Affiliation(s)
- Ollivier Laccourreye
- Université Paris Cité, Service d'Otorhinolaryngologie et de Chirurgie Cervico-Faciale HEGP, AP-HP, Paris, France
| | | | - Fabienne Haroun
- Université Paris Cité, Service d'Otorhinolaryngologie et de Chirurgie Cervico-Faciale HEGP, AP-HP, Paris, France
| | - Dac H Nguyen
- Université Paris Cité, Service d'Otorhinolaryngologie et de Chirurgie Cervico-Faciale HEGP, AP-HP, Paris, France
| | - Philippe Giraud
- Université Paris Cité, Service de Radiothérapie-Oncologie, HEGP, AP-HP, Paris, France
| | - Haitham Mirghani
- Université Paris Cité, Service d'Otorhinolaryngologie et de Chirurgie Cervico-Faciale HEGP, AP-HP, Paris, France
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3
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Alexandre PL, Silveira H, Marques P, Pinto Moura C. Sternohyoid or sternocleidomastoid muscle flap for tracheoesophageal puncture closure in irradiated patients: A CARE case series. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:161-165. [PMID: 37919173 DOI: 10.1016/j.anorl.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 11/04/2023]
Abstract
INTRODUCTION A novel technique for tracheoesophageal puncture (TEP) closure is described in which the sternohyoid muscles are rotated and interposed between the tracheal and esophageal walls. The results of this technique are reported, following CARE guidelines, and compared with those obtained using the sternocleidomastoid flap. A literature review on the techniques previously described for TEP closure in irradiated patients is presented. CASE SERIES The novel technique was performed in six patients in whom the infrahyoid muscles were preserved during total laryngectomy. All received adjuvant radiotherapy. Successful closure was achieved in three cases; in one case a small leak was noted after initial closure and was successfully managed with simple sutures; and the other two failures occurred in patients with diabetes. The sternocleidomastoid flap was performed in five patients (only one with previous radiation) and success was achieved in two patients. In another patient a micro-fistular orifice appeared six months after the operation. DISCUSSION The sternohyoid muscles pose a low morbidity alternative to be considered in surgical TEP closure. Patient selection is a key factor to surgical success, and this technique should be reserved for small to moderate size fistulas and in the absence of multiple impaired wound healing conditions.
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Affiliation(s)
- P L Alexandre
- Department of Otorhinolaryngology, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal.
| | - H Silveira
- Department of Otorhinolaryngology, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - P Marques
- Department of Otorhinolaryngology, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - C Pinto Moura
- Department of Otorhinolaryngology, Centro Hospitalar Universitário de São João, Porto, Portugal; Department of Genetics, Centro Hospitalar Universitário de São João, Faculty of Medicine, University of Porto, Porto, Portugal; I3S, Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
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Tai Y, Zang Y, Liu T, Ma J, Qin L, Ji Y, Dai H, Wang G, Ma L, Liu F. Risk factors and healing factors for pharyngocutaneous fistula after total laryngectomy for laryngeal cancer: An epidemiological study. Int Wound J 2024; 21:e14706. [PMID: 38660912 PMCID: PMC11044006 DOI: 10.1111/iwj.14706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/06/2024] [Accepted: 01/07/2024] [Indexed: 04/26/2024] Open
Abstract
To analyse the risk factors and healing factors of pharyngocutaneous fistula (PCF) in patients with laryngeal cancer after total laryngectomy, and to explore the relevant epidemiology. A retrospective analysis was conducted on laryngeal cancer patients who underwent total laryngectomy in our hospital from January 2010 to December 2022. The 349 patients included in the study were divided into a PCF group of 79 and a non-PCF group of 270. Perform one-way analysis of variance and multivariate logistic analysis on various data of patients included in the statistics, and analyse the risk factors and healing factors of PCF. Smoking, history of radiation therapy for laryngeal cancer, history of chemotherapy for laryngeal cancer, tumour location (larynx, pharynx, oesophagus), preoperative albumin, postoperative proteinaemia, <99 haemoglobin, postoperative haemoglobin, postoperative C-reactive protein (CRP) level are the risk factors for PCF. Also, radiation therapy and postoperative proteinaemia were the main reasons for preventing PCF healing. Smoking history, laryngeal cancer, radiation therapy, albumin, haemoglobin and CRP are risk factors for postoperative PCF after total laryngectomy, while radiation therapy and postoperative hypoalbuminaemia are key factors affecting PCF healing.
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Affiliation(s)
- Yong Tai
- Department of Otorhinolaryngology, People's Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouChina
| | - Yanzi Zang
- Department of Otorhinolaryngology, People's Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouChina
| | - Tongxun Liu
- Department of OtorhinolaryngologyZhongmu County People's HospitalZhengzhouChina
| | - Jiqing Ma
- Department of Otorhinolaryngology, People's Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouChina
| | - Litao Qin
- Henan Provincial Key Laboratory of Genetic Diseases and Functional Genomics, Henan Provincial People's Hospital, Medical Genetics Institute of Henan Province, People's Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouChina
| | - Yuzi Ji
- Department of Otorhinolaryngology, People's Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouChina
| | - Hanqing Dai
- Department of Otorhinolaryngology, People's Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouChina
| | - Guangke Wang
- Department of Otorhinolaryngology, People's Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouChina
| | - Lingcao Ma
- Department of Otorhinolaryngology, People's Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouChina
| | - Fei Liu
- Department of Otorhinolaryngology, People's Hospital of Zhengzhou UniversityZhengzhou UniversityZhengzhouChina
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5
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Chakoma T, Megwalu U, Holsinger FC. Suicide in head and neck oncology. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:115. [PMID: 37598064 DOI: 10.1016/j.anorl.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 08/21/2023]
Affiliation(s)
- T Chakoma
- Stanford University School of Medicine, Stanford, CA, United States
| | - U Megwalu
- Stanford University School of Medicine, Stanford, CA, United States; Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 875, Blake-Wilbur Dr, Stanford, CA 94305, United States
| | - F C Holsinger
- Stanford University School of Medicine, Stanford, CA, United States; Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 875, Blake-Wilbur Dr, Stanford, CA 94305, United States.
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Céruse P, Vergez S, Marie JP, Baujat B, Jegoux F, Malard O, Albert S, Badet L, Blanc J, Deneuve S, Faure F, Fuchsmann C, Morelon E, Philouze P. Laryngeal graft after total laryngectomy in humans: A SWiM analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:81-85. [PMID: 38135563 DOI: 10.1016/j.anorl.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
Evaluation of the results of laryngeal transplantation (LT) in humans. Analysis of 3 bibliographic databases with the keywords "larynx, transplantation, autograft". In total, 626 abstracts were read and 25 articles selected. The main objective was to analyze the characteristics of laryngeal transplant patients. The accessory objectives comprised analysis of operative technique, immunosuppressive treatment and results. Four articles were selected for analysis. Two patients were transplanted after total laryngectomy for laryngeal carcinoma and 2 after laryngeal trauma. Three of the 4 patients had true transplantation with arterial, venous and neural microanastomosis. Two patients were decannulated and the tracheostomy tube was maintained in the other 2. Three of the 4 patients had good-quality phonation and could feed without a gastric tube. One patient died of carcinoma progression and 1 patient had to be explanted 14 years after transplantation. The number of LTs reported is too small for scientific determination of the place of this intervention in laryngology. The published results could, at first sight, suggest that the future of LT is uncertain. However, several elements, also suggest that otolaryngologists should continue to take an interest in this technique.
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Affiliation(s)
- P Céruse
- Centre Hospitalo-Universitaire Lyon Nord, Hospices Civils de Lyon, Lyon, France.
| | - S Vergez
- Centre Hospitalo-Universitaire de Toulouse, Hôpital Larrey, Toulouse, France
| | - J-P Marie
- Centre Hospitalo-Universitaire de Rouen, Rouen, France
| | - B Baujat
- Centre Hospitalo-Universitaire de Tenon, Paris, France
| | - F Jegoux
- Centre Hospitalo-Universitaire de Rennes, Rennes, France
| | - O Malard
- Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | - S Albert
- Groupe Hospitalier Ambroise-Paré, Paris, France
| | | | - J Blanc
- Centre Hospitalo-Universitaire Lyon Nord, Hospices Civils de Lyon, Lyon, France
| | - S Deneuve
- Centre Hospitalo-Universitaire de Rouen, Rouen, France
| | - F Faure
- Centre Hospitalo-Universitaire Lyon Nord, Hospices Civils de Lyon, Lyon, France
| | - C Fuchsmann
- Centre Hospitalo-Universitaire Lyon Nord, Hospices Civils de Lyon, Lyon, France
| | | | - P Philouze
- Centre Hospitalo-Universitaire Lyon Nord, Hospices Civils de Lyon, Lyon, France
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7
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Céruse P, Albert S, Baujat B, Blanc J, Fuchsmann C, Faure F, Jegoux F, Marie JP, Malard O, Morelon E, Philouze P, Soldea V, Vergez S, Badet L. 2023: First laryngeal transplantation in France by the "ECLAT" group! Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:1-2. [PMID: 38057230 DOI: 10.1016/j.anorl.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Affiliation(s)
- P Céruse
- Centre hospitalier Lyon Nord, hospices civils de Lyon, université Lyon 1, Lyon, France.
| | - S Albert
- Centre hospitalier Ambroise-Paré, Paris, France
| | - B Baujat
- Centre hospitalier de Tenon, université la Sorbonne, Paris, France
| | - J Blanc
- Centre hospitalier Lyon Nord, hospices civils de Lyon, université Lyon 1, Lyon, France
| | - C Fuchsmann
- Centre hospitalier Lyon Nord, hospices civils de Lyon, université Lyon 1, Lyon, France
| | - F Faure
- Centre hospitalier Lyon Centre, hospices civils de Lyon, université Lyon 1, Lyon, France
| | - F Jegoux
- Centre hospitalier de Rennes, université de Rennes 1, Rennes, France
| | - J-P Marie
- Centre hospitalier de Rouen, université de Rouen Normandie, Rouen, France
| | - O Malard
- Centre hospitalier de l'Hôtel Dieu, université de Nantes, Nantes, France
| | - E Morelon
- Centre hospitalier Lyon Centre, hospices civils de Lyon, université Lyon 1, Lyon, France
| | - P Philouze
- Centre hospitalier Lyon Nord, hospices civils de Lyon, université Lyon 1, Lyon, France
| | - V Soldea
- Centre hospitalier Lyon Est, hospices civils de Lyon, Lyon, France
| | - S Vergez
- Hôpital Larrey, université de Toulouse III Paul-Sabatier, Toulouse, France
| | - L Badet
- Centre hospitalier Lyon Centre, hospices civils de Lyon, université Lyon 1, Lyon, France
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Hu Z, Guo X, Chen L, Lei W. Transnasal negative pressure therapy for accelerating healing and improving the prognosis of pharyngocutaneous fistula. Head Neck 2023; 45:2809-2818. [PMID: 37695059 DOI: 10.1002/hed.27505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/04/2023] [Accepted: 08/23/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND Pharyngocutaneous fistula (PCF) is one of the most common complications of total laryngectomy. This study is to investigate the efficacy of a novel platform called transnasal negative pressure therapy (TNPT) in the management of PCF. METHODS We retrospectively reviewed 47 patients who underwent total laryngectomy between April 2015 and February 2021 and developed PCF in our hospital. We focused on the healing rate, dressing change frequency, and healing time between the TNPT and non-TNPT groups. The 2 years overall survival (OS) was compared through the log-rank test. RESULTS There were 18 patients in the TNPT group and 29 in the non-TNPT group. There was no significant between-group difference in the healing rate (chi-square test). However, the frequency of dressing changes was significantly lower (p < 0.001) and the healing time was significantly shorter (p = 0.0194) in the TNPT group than in the non-TNPT group. The 2-year OS rate was significantly higher in the TNPT group (p = 0.0473, log-rank test). CONCLUSION TNPT promoted wound healing after surgery for PCF and improved the 2-year OS rate. This tool is worthy of clinical application and promotion.
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Affiliation(s)
- Zhangwei Hu
- Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, China
| | - Xueqin Guo
- Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, China
| | - Lin Chen
- Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, China
| | - Wenbin Lei
- Department of Otolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Otorhinolaryngology Institute, Sun Yat-sen University, Guangzhou, China
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Laccourreye O, Garcia D, Guiquerro S, Mudry A. 1885: First total laryngectomy and artificial larynx in France. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:243-245. [PMID: 36858931 DOI: 10.1016/j.anorl.2023.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
This year, 2023, is the 150th anniversary of the first total laryngectomy for cancer, by Theodor Billroth. The authors reconstruct the conditions under which, on March 12, 1885, this operation was then performed for the first time in France, by Leon Labbé, and present the man himself, and also M. Cadier, the inventive genius who designed the first artificial larynx used in this country.
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Affiliation(s)
- O Laccourreye
- Université Paris Cité, service d'otorhinolaryngologie et de chirurgie cervico-faciale HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
| | - D Garcia
- Hôpital français, SO1Pho Phuong Mai District Dong Da, Hanoi, Vietnam
| | - S Guiquerro
- Université Paris Cité, bibliothèque universitaire Necker, 160, rue de Vaugirard, 75015 Paris, France
| | - A Mudry
- Department of Otolaryngology, Head & Neck Surgery, Stanford University School of Medicine, 801, Welch road, Stanford, CA, 94305-5739, USA
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Neijman M, Heirman AN, van Sluis KE, van den Brekel MWM. Singing after total laryngectomy. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:253-254. [PMID: 37069026 DOI: 10.1016/j.anorl.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/20/2023] [Accepted: 03/23/2023] [Indexed: 04/19/2023]
Affiliation(s)
- M Neijman
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, Noord-Holland, 1066 CX, The Netherlands; Amsterdam Center for Language and Communication, University of Amsterdam, Amsterdam, The Netherlands.
| | - A N Heirman
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, Noord-Holland, 1066 CX, The Netherlands
| | - K E van Sluis
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, Noord-Holland, 1066 CX, The Netherlands
| | - M W M van den Brekel
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam, Noord-Holland, 1066 CX, The Netherlands; Amsterdam Center for Language and Communication, University of Amsterdam, Amsterdam, The Netherlands; Department of Oral and Maxillofacial Surgery, Amsterdam University Medical Center (AUMC), Amsterdam, The Netherlands
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Babin E, Heutte N, Humbert M, Laccourreye O. Sex-related quality of life after total laryngectomy for cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:121-126. [PMID: 37142505 DOI: 10.1016/j.anorl.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVES Analysis of the quality of sexual life after total laryngectomy (TL) for cancer. MATERIAL AND METHODS The Cochrane, PubMed, Embase, ClinicalKey and Science Direct databases were searched using the keywords: "total laryngectomy, sexual function, sexual behavior, sexual complications, sexual dysfunction, sexuality, intimacy". The abstracts of 69 articles were read by two of the authors and 24 articles were selected. The main endpoint was the impact of impairment of quality of sexual life after TL for cancer and the methods used to assess this. The secondary endpoints were the type of sexual impairment, associated variables and their treatment. RESULTS The study population consisted of 1511 TL patients aged 21 to 90 years, with a male/female sex ratio of 7.49. One of the 7 validated Likert scales was used in 79% of the articles to evaluate impairment of sexual quality of life. Impaired quality of sexual life was reported by 47% of patients on average (range, 5-90%). Erectile and ejaculatory function and ejaculatory behavior of male patients decreased after TL. Other impairments comprised decreases in libido, frequency of sexual intercourse and satisfaction. Tracheostomy, advanced disease stage, young age and associated depression were factors for impairment. In all, 23% of patients reported lack of postoperative support in this area. CONCLUSION The quality of sexual life is severely impacted by TL for cancer. The present data are a source of information and should be taken into account before carrying out TL. A common information tool needs to be developed. There is patient demand for improved management of sexuality.
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Affiliation(s)
- E Babin
- Service d'otorhinolaryngologie et de chirurgie cervicofaciale, laboratoire ANTICIPE, université de Caen, CHU de Côte-de-Nacre, 14000 Caen, France.
| | - N Heutte
- CETAPS UR3832, université de Rouen, boulevard Siegfried, 76821 Mont-Saint-Aignan cedex, France; Service de recherche clinique, CLCC François-Baclessec, Caen, France
| | - M Humbert
- Service d'otorhinolaryngologie et de chirurgie cervicofaciale, laboratoire ANTICIPE, université de Caen, CHU de Côte-de-Nacre, 14000 Caen, France
| | - O Laccourreye
- Service d'otorhinolaryngologie et de chirurgie cervicofaciale, HEGP, université de Paris-Cité, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
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Laccourreye O, Mirghani H, Guiquerro S, Quer M, Giraud P. Perception of survival/laryngeal preservation trade-off in advanced T-stage laryngeal cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:77-80. [PMID: 36642664 DOI: 10.1016/j.anorl.2022.12.008] [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: 01/15/2023]
Abstract
OBJECTIVES To evaluate the perception of the survival/laryngeal preservation trade-off in advanced T-stage laryngeal cancer. MATERIAL AND METHODS The Cochrane, PubMed, Embase, and Science Direct databases were searched using the keywords "cancer, neoplasms, trade-off. One hundred and eighty four articles were found; 176 of these, without data in the Abstract documenting the survival/laryngeal preservation trade-off for advanced T-stage laryngeal cancer, were excluded. Eight articles, totaling 1,052 interviewees, were read to document modalities of evaluation, trade-off thresholds, and variables influencing the perception of trade-off. RESULTS Evaluation of trade-off was based on responses in group discussions, interviews and questionnaires and on patient file analysis. One study reported that 28.2% of respondents could not make a decision between options, and in 4 studies 22% to 80% of respondents would not consider jeopardizing survival. A mean 2-3 year gain (range, 6 months to 5 years) in survival was required before preferring total laryngectomy to chemoradiotherapy. The percentage loss of disease-free survival tolerated by respondents who would consider a trade-off to preserve the larynx ranged from 5% to 100%, for a median 30%. Variables influencing trade-off comprised respondent status (patient/healthcare provider/healthy subject) and characteristics (job, having children) and treatment data (amount and modalities of information delivered, survival estimates after radiation therapy, health status after treatment). A time for reflection after diagnosis and good quality information were important for respondents. CONCLUSION Several consequences emerge from these data. The first is to consider induction chemotherapy, to give the patient time to make an informed choice. The second is to not to give up teaching total laryngectomy The third is to determine whether the team's own results match the information delivered to patients.
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Affiliation(s)
- O Laccourreye
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, université Paris Cité, HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
| | - H Mirghani
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, université Paris Cité, HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - S Guiquerro
- Université Paris Cité, bibliothèque universitaire médicale Necker, 156, rue Vaugirard, 75730 Paris Cedex 15, France
| | - M Quer
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, université Autonome de Barcelone, Hospital de la Santa Creu i Sant Pau, 90, rue Mas Casanovas, 08041 Barcelona, Spain
| | - P Giraud
- Service d'otorhinolaryngologie et de chirurgie cervico-faciale, université Paris Cité, HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
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