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Mazerolle P, Fuchsmann C, Schultz P, Benmoussa N, Malard O, Bozec A, Deneuve S, Folia M, Perréard M, Lasne-Cardon A, Chabrillac E, Vergez S, Chaltiel L, Dupret-Bories A. Salvage total glossectomy and total glosso-laryngectomy: Are they worth it? A GETTEC French multicenter study. Oral Oncol 2022; 130:105896. [PMID: 35567979 DOI: 10.1016/j.oraloncology.2022.105896] [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: 02/11/2022] [Revised: 04/12/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Salvage total glossectomy (TG) or total glosso-laryngectomy (TGL) remain controversial, as highly morbid procedures. The objective was to describe oncological and functional outcomes after salvage TG or TGL. METHODS We performed a multicenter retrospective study, including patients with previous neck irradiation undergoing TG or TGL for squamous cell carcinoma involving the base of tongue. RESULTS We included 42 patients: 27 in the TG group and 15 in the TGL group. For the entire cohort, median OS and DFS were estimated at 19 months (95% IC [14-44]) and 10 months (95% IC [7-13]) respectively, with no difference between the two groups. After a median follow-up of 90 months, 10 patients (24%) were alive and free of disease. Att he end of follow-up, we noted a gastrostomy dependency of 89% and 87 %respectively in the TG and TGL group, and 48% of patients in the TG group had a tracheotomy. CONCLUSION Although local control is difficult to achieve after salvage TG or TGL, these procedures are associated with acceptable survival and chance of cure for a last-resort situation. TG and TGL can be proposed in selected motivated patients after careful shared decision-making.
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Affiliation(s)
- Paul Mazerolle
- Department of Surgery, University Cancer Institute Toulouse - Oncopole, University Hospital of Toulouse, Toulouse, France
| | - Carine Fuchsmann
- Department of Otolaryngology-Head Neck Surgery, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Philippe Schultz
- Department of Otorhinolaryngology, Centre Hospitalo-Universitaire de Hautepierre, Strasbourg, France
| | - Nadia Benmoussa
- Department of Head and Neck Surgical Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, 94805, France
| | - Olivier Malard
- Department of Head and Neck Surgery, University Hospital of Nantes, France
| | - Alexandre Bozec
- Department of Head and Neck Surgery, Institut Universitaire de la Face et du Cou, Nice, France
| | - Sophie Deneuve
- Department of Oncologic Surgery, Léon Bérard Center, Lyon, France
| | - Mireille Folia
- Department of Otolaryngology-Head and Neck Surgery, François-Mitterrand University Hospital Center, Dijon, France
| | - Marion Perréard
- Department of Head and Neck Surgery, University Hospital of Caen, France
| | - Audrey Lasne-Cardon
- Department of Head and Neck Surgery, François Baclesse Cancer Center, Caen, France
| | - Emilien Chabrillac
- Department of Surgery, University Cancer Institute Toulouse - Oncopole, University Hospital of Toulouse, Toulouse, France
| | - Sébastien Vergez
- Department of Surgery, University Cancer Institute Toulouse - Oncopole, University Hospital of Toulouse, Toulouse, France
| | - Léonor Chaltiel
- Biostatistics Unit, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole Toulouse, France
| | - Agnès Dupret-Bories
- Department of Surgery, University Cancer Institute Toulouse - Oncopole, University Hospital of Toulouse, Toulouse, France.
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Burnham AJ, Ottenstein L, Boyce BJ, Kaka AS, El-Deiry MW, Baddour HM, Patel MR, Gross JH, Schmitt NC. Survival, functional, and quality of life outcomes between total glossectomy with and without total laryngectomy: A narrative review. Am J Otolaryngol 2022; 43:103440. [PMID: 35398743 DOI: 10.1016/j.amjoto.2022.103440] [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: 02/24/2022] [Accepted: 04/03/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND A total glossectomy (TG) may be required for advanced tongue tumors. TG with total laryngectomy (TGL) may be indicated in some cases with tumor extension into the larynx or high risk of aspiration. Total glossectomy with laryngeal preservation (TGLP) may preserve phonation ability relative to TGL, yet TGLP may increase the risk of aspiration. METHODS For this narrative review, we performed a comprehensive literature search of studies relevant to TG and TGL. Clinical studies investigating survival, functional outcomes, and quality of life in following TGLP or TGL were of particular interest. RESULTS Few studies in the literature directly compare survival, functional, and quality of life (QOL) outcomes between TGLP and TGL. TGLP is associated with intelligible speech. However, studies investigating gastrostomy tube dependence following TGLP versus TGL have generated conflicting results. CONCLUSION Further research on functional and QOL outcomes in patients undergoing TGL or TGLP is needed.
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Kadota H, Kamizono K, Yoshida S, Hanada M, Inatomi Y, Fukushima S, Nakashima T, Yasumatsu R, Nakagawa T. Pharyngeal reconstruction by anterolateral thigh flap with vastus lateralis muscle transfer for effective swallowing after total glossolaryngectomy: A case report. Head Neck 2019; 41:E120-E124. [PMID: 30861231 DOI: 10.1002/hed.25735] [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: 07/18/2018] [Revised: 10/31/2018] [Accepted: 02/19/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND We report a novel reconstruction technique that maintained effective swallowing after total glossolaryngectomy (TGL) by restoring pharyngeal constriction using a vascularized vastus lateralis muscle transfer. METHODS A 65-year-old male with recurrent tongue cancer underwent TGL and anterolateral thigh flap reconstruction with the vastus lateralis muscle. The bilateral cut ends of the remaining posterior pharyngeal wall constrictor muscle were sutured to the transferred vastus lateralis muscle so that the two muscles encircled the reconstructed pharynx. The femoral nerve of the vastus lateralis muscle was coapted to the hypoglossal nerve. RESULTS Videofluorographic examination showed the contrast bolus flowing smoothly with little assistance from gravity. Laryngoscopic examination showed circumferential constriction of the reconstructed pharynx. The patient could swallow soft food without placing the bolus in his posterior oral cavity or drinking simultaneously. CONCLUSION The restoration of pharyngeal constriction introduces the possibility of functional swallowing in patients after TGL.
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Affiliation(s)
- Hideki Kadota
- Department of Plastic and Reconstructive Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Kenichi Kamizono
- Department of Plastic and Reconstructive Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Sei Yoshida
- Department of Plastic and Reconstructive Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Masuo Hanada
- Department of Plastic and Reconstructive Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Yusuke Inatomi
- Department of Plastic and Reconstructive Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Seita Fukushima
- Department of Plastic and Reconstructive Surgery, Kyushu University Hospital, Fukuoka, Japan
| | - Torahiko Nakashima
- Division of Otorhinolaryngology and Head and Neck Surgery, National Kyushu Medical Center, Fukuoka, Japan
| | - Ryuji Yasumatsu
- Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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