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Peng Z, Li Y, Jin L, Tao X, Cai X, Feng J, Liu R, Zhang Q, Li L. Retrospective analysis of therapeutic effect and prognostic factors on early glottic carcinoma. Photodiagnosis Photodyn Ther 2016; 15:167-71. [PMID: 27378675 DOI: 10.1016/j.pdpdt.2016.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 06/21/2016] [Accepted: 06/23/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the therapeutic effect of surgery, radiotherapy and photodynamic therapy on early glottic carcinoma and prognostic factors. METHODS Retrospective analysis of 202 cases with early glottic carcinoma (Tis-T2N0M0) underwent surgery (n=152), radiotherapy (n=20) and PDT (n=30) from 2000 to 2013 The KPS score, the disease-free survival (DFS), overall survival (OS), local control (LC), larynx preservation rate, laryngeal function were evaluated. The methods of χ (2)test or Fisher's exact probability method, Kaplan Meier method, log-rank test of Kaplan-Meier method, Cox proportional hazards model were used to analyze the data. RESULTS There was no statistical significance in OS, DFS and LC among the three groups. The laryngeal function preservation rate of RT group, PDT group and Surgery group were 90%, 86.7% and 65.1% respectively, with the former two groups significantly superior to Surgery group. While there is no statistical significance between RT group and PDT group. Single factor analysis showed that KPS score before treatment, vocal fold mobility limitation and differentiation degree could have an effect on prognosis. Multivariate regression analyses indicated that anterior commissure invasion, T stage and KPS score before treatment were independent adverse prognostic factors for OS. T stage and differentiation degree were adverse prognostic factors for DFS. T stage was also an adverse factor of LC. Thirty-three cases experienced local recurrence or cervical lymph node metastasis. Three groups showed no statistical difference in local recurrence or lymph node metastasis, with twenty-two cases in Surgery group, four in RT group and seven in PDT group. CONCLUSIONS The therapeutic effect was approximate in surgery group, radiotherapy group and photodynamic group, and all three treatment regimens achieved good clinical effect. Radiotherapy and photodynamic therapy may be the first or very important treatment on early stage glottic squamous cell cancer (Tis∼T2N0M0). However only 6 patients underwent PDT for T2 disease, making definitive treatment conclusions for this subgroup unclear.
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Affiliation(s)
- Zhongzhong Peng
- Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China
| | - Yanbing Li
- Department of Oncology, Jiujiang First Hospital, Jiujiang, China
| | - Longwei Jin
- Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China
| | - Xiaopeng Tao
- Department of Endoscopy, Cancer Center of Guangzhou Medical University, China
| | - Xiaojun Cai
- Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China
| | - Jieni Feng
- The Third Hospital of Wenzhou Medical University, Ruian, Zhejiang 325200, China
| | - Rengeng Liu
- Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China
| | - Qianyu Zhang
- Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China
| | - Libo Li
- Cancer Center, Southern Medical University, Guangzhou 510315, China; Traditional Chinese Medicine-Integrated Hospital, Southern Medical University, Guangzhou 510315, China.
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Laccourreye O, Ishoo E, de Mones E, Garcia D, Kania R, Hans S. Supracricoid Hemilaryngopharyngectomy in Patients with Invasive Squamous Cell Carcinoma of the Pyriform Sinus. Ann Otol Rhinol Laryngol 2016; 114:25-34. [PMID: 15697159 DOI: 10.1177/000348940511400106] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
On the basis of a retrospective review of an inception cohort of 135 patients, with an isolated, previously untreated, moderately differentiated to well-differentiated invasive squamous cell carcinoma of the pyriform sinus and a minimum of 3 years of follow-up, consecutively managed with a supracricoid hemilaryngopharyngectomy (SCHLP) at a single tertiary referral care center and locally controlled, the authors review in detail the surgical technique, highlight the potential technical pitfalls, and document the complications and long-term functional outcome. The overall postoperative mortality rate was 3.7%. The overall mortality rate directly related to the SCHLP was 1.5%. A significant surgical complication directly related to SCHLP completion was noted in 9.6% of cases. The mean lengths of time to removal of the tracheotomy and feeding tubes were 9 and 19 days, respectively. The mean duration of hospitalization was 25 days. Normal swallowing without aspiration by the first postoperative month was noted in 64.6% of patients. Temporary grade 1–2 aspiration and grade 3 aspiration were noted in 26.9% and 8.5% of patients, respectively. Overall, in our series, successful oral alimentation without gastrostomy or completion total laryngectomy was achieved in 91.9% of patients by the first postoperative year, and the incidences of permanent gastrostomy, completion total laryngectomy, and aspiration-related death were 0.7%, 1.5%, and 0.7%, respectively. A significant late complication related to the use of postoperative radiotherapy was noted in 26.5% of cases. From a functional point of view, such results suggest that SCHLP should be integrated among the various conservation treatment options available to patients with selected invasive squamous cell carcinoma of the pyriform sinus.
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Affiliation(s)
- Ollivier Laccourreye
- Department of Otorhinolaryngology-Head and Neck Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, University of Paris V, Paris, France
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Marcotullio D, de Vincentiis M, Iannella G, Bigelli C, Magliulo G. Surgical treatment of T1b glottic tumor, 10-years follow-up. Eur Rev Med Pharmacol Sci 2014; 18:1212-1217. [PMID: 24817297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND The TNM classification of glottic tumors defined T1b as a tumor involving both vocal cords with normal mobility of such. In the last fifteen years, in the medical literature, the role of open surgery for management of laringeal cancer has decreased considerably owing to the development of transoral laser microsurgery which is an oncologically and functionally reliable treatment particularly for early glottic cancers. AIM Report the efficacy of different surgical techniques (laser CO2 cordectomy or supracricoid partial laryngectomy) in T1b glottic cancers treatment with a 10-years follow-up. PATIENTS AND METHODS 92 patients with T1b glottic cancer undergoing surgery between 1986 and 2002, of which 39 were treated with CO2 laser cordectomy while 53 with supracricoid partial laryngectomy (14 crico-hyoid-pexy and 39 crico-hyoid-epiglotto-pexy). Each of the three groups was recalled and evalued with the aim to calculate the survival, initially at 3 and 5 years and thereafter, provide a 10 years follow-up, including local recurrence. RESULTS 10 years absolute survival of the 39 patient treated with CO2 laser was 56.25%, while that of the two groups subjected to supracricoid partial laryngectomy was respectively of 66.6% for crico-hyoid-pexy and 58.82% for crico-hyoid-epiglotto-pexy. CONCLUSIONS Our data suggest an excellent absolute survival also after 10 years follow-up. Since both the CO2 laser and supracricoid partial laryngectomy show similar local control and survival rates we can't determine with certainty the best therapeutic approach as claimed by a great number of literature studies.
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Affiliation(s)
- D Marcotullio
- "Organi di Senso" Department, "Sapienza" University, Rome, Italy.
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Ma Y, Liu L, Huang D, Wang J, Wu W, Liu M, Zhao J. [Retrospective analyses of postoperative survival of laryngeal carcinoma patients at late stage]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2013; 27:844-846. [PMID: 24364114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To compare the postoperative survival rate of laryngeal carcinoma patient at stage III or IV whom accepted partial laryngectomy and total laryngectomy. METHOD We performed a retrospective cohort follow-up study of 126 patients of stage III or IV who underwent operation for laryngeal carcinoma in Chinese PLA General Hospital between January, 2005 and December, 2009. Survival rates were calculated by product-limit method. RESULT There were 80 patients at stage III and 46 patient at stage IV. Sixty five patients underwent partial laryngectomy and 61 patients underwent total laryngectomy. There were 24 patients in whole group died in the 5 years, 15 of them underwent partial and 9 accepted total laryngectomy. The 5-years survival rate of partial and total group were 62.58% and 68.74% respectively. The survival curve of both groups had no significant difference (P < 0.05). CONCLUSION For laryngeal carcinoma patients at later stage, with suitable operative indication, the partial laryngectomy could achieve an acceptable effect as well as total laryngectomy.
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Affiliation(s)
- Yueying Ma
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Liangfa Liu
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Deliang Huang
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jialing Wang
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Wenming Wu
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Mingbo Liu
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jiandong Zhao
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, 100853, China
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Lei WB, Jiang AY, Chai LP, Zhu XL, Wang ZF, Wen YH, Su ZZ, Wen WP. Middle frontal horizontal partial laryngectomy (MFHPL): a treatment for stage T1b squamous cell carcinoma of the glottic larynx involving anterior vocal commissure. PLoS One 2013; 8:e52723. [PMID: 23326350 PMCID: PMC3541376 DOI: 10.1371/journal.pone.0052723] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Accepted: 11/21/2012] [Indexed: 11/25/2022] Open
Abstract
Objective The therapeutic effect of middle frontal horizontal partial laryngectomy (MFHPL) in treating stage T1b squamous cell carcinoma of the glottic larynx involving anterior vocal commissure (AVC) was compared with that of the anterior frontolateral vertical partial laryngectomy (AFVPL). The feasibility and practical significance of MFHPL in clinical application was discussed in the present study. Methods From January 1996 to January 2010, a total of 65 patients diagnosed with stage T1bN0M0 glottic laryngeal cancer were treated with MFHPL or AFVPL. The postoperative complications, glottic reconstruction, recurrence rate, voice quality and survival rates were evaluated and compared between two treatments. Results AFVPL and MFHPL were performed in 34 and 31 patients, respectively. Flexible fiberoptic laryngoscopy revealed that in the MFHPL-treated patients the reconstructed glottis was spacious and symmetric. In contrast, AFVPL treatment resulted in irregular glottic area with poor symmetry and tubular glottis. The incidence of postoperative laryngeal stenosis significantly differed between the MFHPL- and AFVPL-treated groups (P = 0.025). No significant difference was detected in the 3- and 5-year overall- or tumor-free survival rates between two treatments. The Voice Handicap Index (VHI) and maximum phonation time (MPT) after surgery were 51.0±12.99 and 12.42±3.44 sec in the AFVPL-treated group; while in the MFHPL-treated patients they were 31.81±7.48 and 7.65±1.98 sec, respectively. Both differences in VHI (P = 0.012) and MPT (P = 0.024) were significant between two treatments. Conclusions MFHPL was comparable to AFVPL with respect to postoperative complications, recurrence rate and survival rates, but possessed advantages over AFVPL in terms of the incidence of laryngeal stenosis and voice quality. Our study indicated that MFHPL has a potential value in clinical practice of treating stage T1b squamous cell carcinoma of the glottic larynx involving AVC.
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Affiliation(s)
- Wen-bin Lei
- Otorhinolaryngology Hospital, Otorhinolaryngology Institute, The First Affiliated Hospital, Sun Yat-sen University, National Key Department of Otorhinolaryngology of People's Republic of China, Guangzhou, People's Republic of China
| | - Ai-yun Jiang
- Otorhinolaryngology Hospital, Otorhinolaryngology Institute, The First Affiliated Hospital, Sun Yat-sen University, National Key Department of Otorhinolaryngology of People's Republic of China, Guangzhou, People's Republic of China
| | - Li-ping Chai
- Otorhinolaryngology Hospital, Otorhinolaryngology Institute, The First Affiliated Hospital, Sun Yat-sen University, National Key Department of Otorhinolaryngology of People's Republic of China, Guangzhou, People's Republic of China
| | - Xiao-lin Zhu
- Otorhinolaryngology Hospital, Otorhinolaryngology Institute, The First Affiliated Hospital, Sun Yat-sen University, National Key Department of Otorhinolaryngology of People's Republic of China, Guangzhou, People's Republic of China
| | - Zhang-feng Wang
- Otorhinolaryngology Hospital, Otorhinolaryngology Institute, The First Affiliated Hospital, Sun Yat-sen University, National Key Department of Otorhinolaryngology of People's Republic of China, Guangzhou, People's Republic of China
| | - Yi-hui Wen
- Otorhinolaryngology Hospital, Otorhinolaryngology Institute, The First Affiliated Hospital, Sun Yat-sen University, National Key Department of Otorhinolaryngology of People's Republic of China, Guangzhou, People's Republic of China
| | - Zhen-zhong Su
- Otorhinolaryngology Hospital, Otorhinolaryngology Institute, The First Affiliated Hospital, Sun Yat-sen University, National Key Department of Otorhinolaryngology of People's Republic of China, Guangzhou, People's Republic of China
- * E-mail: (ZS); (WW)
| | - Wei-ping Wen
- Otorhinolaryngology Hospital, Otorhinolaryngology Institute, The First Affiliated Hospital, Sun Yat-sen University, National Key Department of Otorhinolaryngology of People's Republic of China, Guangzhou, People's Republic of China
- * E-mail: (ZS); (WW)
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Hu C, Wang B, Huangfu H, Liu T, Xia L, Zhou L. [Survival analysis of 315 cases of laryngectomy]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2007; 21:466-7. [PMID: 17650820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To investigation the clinic long-term result and explore the prognostic factor of patients with laryngectomy. METHOD Three hundred and fifteen patients with laryngectomy were analysed. The survival rate and the cause of death were collected from this study. RESULT Five years later, 233 cases were still alive, 60 cases were dead, 22 cases failed to be followed-up. Overall 5-year survival rate was 73.97%, 5-year survival rate for patients of early stage was 82.69. Whereas, for patients of late stage was 62.64%. Five year survival rate for patients of supraglottic carcinoma, glottic carcinoma, subglottic carcinoma and transglottic carcinoma was respectively 73.76%, 82. 55%, 55.56%, 68.75%. Five year survival rate for patients with partial laryngectomy was 79.89%, whereas, for total laryngectomy was 1.03%. The cause of death were local recurrence and cervical glands metastasis. CONCLUSION Early diagnosis was the key points to both larynx preservation and survival rate. for improving survival rate, we should handle the indications strictly. remain sufficient security cutting edge and follow-up visit.
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Affiliation(s)
- Changchen Hu
- Department of Otorhinolaryngology, First Clinical Hospital of Shanxi Medical University, Taiyuan, 030001, China
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Holsinger FC, Funk E, Roberts DB, Diaz EM. Conservation laryngeal surgery versus total laryngectomy for radiation failure in laryngeal cancer. Head Neck 2006; 28:779-84. [PMID: 16637055 DOI: 10.1002/hed.20415] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Total laryngectomy is the standard of care for surgical salvage of radiation failure in laryngeal cancer. However, the role of conservation laryngeal surgery in this setting remains unclear. The objective was to compare the efficacy of conservation versus total laryngectomy for salvage of radiation failure in patients who initially presented with T1 or T2 squamous cancer of the larynx. METHODS A 21-year retrospective analysis of patients who received surgery at a single comprehensive cancer center after definitive radiation therapy is reported. At recurrence, the patients were reevaluated and then underwent a total laryngectomy or, if possible, a conservation laryngeal procedure. The charts of 105 patients who failed radiation treatment for primary laryngeal cancer and who subsequently underwent surgical salvage were reviewed for this study. Eighty-nine were male (84.8%). The mean age was 60.3 years. The median follow-up time after surgery was 69.4 months. Most patients with recurrence after radiotherapy required total laryngectomy (69.5%; 73/105). Conservation laryngeal surgery was performed for 32 patients (31.5%). Concomitant neck dissections were performed on 45 patients (45.5%). RESULTS In 14 patients, local or regional recurrence developed after salvage surgery: 9 patients after total laryngectomy (12.3%; 9/73), and 5 patients (15.6%; 5/32) after conservation laryngeal surgery. This difference was not statistically significant, nor was there a difference in disease-free interval for the two procedures (p = .634, by log-rank test). Distant metastasis developed in 13 patients. Most developed in the setting of local and/or regional recurrence, but distant metastasis occurred as the only site of failure in 6 of the patients who had undergone total laryngectomy but in 1 of the conservation surgery patients treated for a supraglottic laryngeal cancer. The overall mortality for patients who underwent total laryngectomy was also higher: 73.74% (54/73) versus 59.4% (19/32) for patients who underwent a conservation approach (p = .011 by log-rank test). CONCLUSIONS Although conservation laryngeal surgery was possible in a few patients with local failure after radiotherapy, conservation laryngeal surgery is an oncologically sound alternative to total laryngectomy for these patients.
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Affiliation(s)
- F Christopher Holsinger
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 441, Houston, Texas 77030-4009, USA.
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Dedivitis RA, Guimarães AV, Guirado CR. Outcome after partial frontolateral laryngectomy. Int Surg 2005; 90:113-8. [PMID: 16119718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
The purpose of this study was to determine the recurrence rate and the long-term survival of patients treated with frontolateral laryngectomy for early glottic cancer. The study is a retrospective analysis of a cohort of patients who underwent frontolateral laryngectomy from 1995 to 2002 with a median follow-up of 48 months. This was a consecutive series of 30 patients with T1bN0 and T2N0 vocal fold carcinoma. Previously treated patients were excluded. Surgical treatment consisted of frontolateral partial vertical laryngectomy and reconstruction with bipedicle sternohyoid muscle flap. Twenty-five patients have been alive with no evidence of the disease. The median follow-up was 48 months (range, 6-85 months). Five patients experienced local recurrence. One of them underwent salvage partial hemilaryngectomy, and 4 underwent wide-field total laryngectomy with adjuvant postoperative radiation therapy. Four of five patients with retreatment were ultimately salvaged, with a median follow-up of 30 months. We had one death caused by the disease. Frontolateral laryngectomy is an efficient treatment for selected cases of early glottic carcinoma.
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Affiliation(s)
- Rogério A Dedivitis
- Departments of Head and Neck Surgery, Hospital Ana Costa and Irmandade da Santa Casa da Misericórdia de Santos, Santos, Brazil.
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Abstract
BACKGROUND Patients with advanced cancers of the larynx and hypopharynx have been treated with total laryngectomy at the Department of Head and Neck Surgery, Royal Prince Alfred Hospital, Sydney in the past. Increasingly, these patients are being managed with organ-sparing protocols using chemo-therapy and radiotherapy. The aim of the present study was to review complication, recurrence and survival rates following total laryngectomy. METHODS Patients who had total laryngectomy for squamous carcinomas of the larynx or hypopharynx between 1987 and 1998 and whose clinicopathological data had been prospectively accessioned onto the computerized database of the Department of Head and Neck Surgery, Royal Prince Alfred Hospital, were reviewed. Patients whose laryngectomy was a salvage procedure for failed previous treatment were included. RESULTS A total of 147 patients met the inclusion criteria for the study, including 128 men and 19 women with a median age of 63 years. Primary cancers involved the larynx in 90 patients and hypopharynx in 57. There were 30 patients who had recurrent (n = 24) or persistent disease (n = 6) after previous treatment with radiotherapy (26 larynx cases and four hypopharynx cases). Pharyngo-cutaneous fistulas occurred in 26 cases (17.7%) and, using multivariate analysis, the incidence did not correlate with T stage, previous treatment or concomitant neck dissection. Local control rates were 86% for the larynx and 77% for the hypo-pharynx groups and neck control was 84% and 75%, respectively. Five-year survival for the larynx cancer group was 67% and this was significantly influenced by T stage and clinical and pathological N stage. Survival in the hypopharynx group was 37% at 5 years and this did not significantly correlate with T or N stage. There was a non-significant trend to improved survival among previously treated patients whose laryngectomy was a salvage procedure. CONCLUSION Patients with cancer of the larynx had a significantly better survival following total laryngectomy than patients with hypopharyngeal cancer. Those whose laryngectomy was carried out as a salvage procedure following failed previous treatment did not have a worse outcome than previously untreated patients.
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Affiliation(s)
- Francis T Hall
- Sydney Head and Neck Cancer Institute, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Diallo BK, Diouf R, Tall A, Ndiaye IC, Kpemissi E, Diop EM. [Partial laryngectomies at the University Hospital Center of Dakar]. Dakar Med 2000; 45:42-4. [PMID: 14666789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Our experience on partial laryngectomies stretched on a period of 16 years. In an unfavorable medical environment, we issue our indicative criteria throughout this experience. From January 1st 1981 to December, 31st 1996, 14 patients have had a partial laryngectomy in University Hospital Center of Dakar. The average year was 56 and the sex-ratio was 1 woman out of 13 men. There were 13 carcinomas and 1 cas of acute dysplasia. 4 patients have had vertical partial laryngectomy, 5 have had a horizontal partial laryngectomy and 5 a partial laryngectomy on the upper out of the cricoid cartilage with the ganglia. After a 3 years close look, on 10 patients, we noted that 1 died, 1 disappeared, and 8 still were living. Carcinological failures consisted in 3 development by stages and 1 cas of a 2nd localisation. As for as functional results, the removal of the nozzle and the elimination of the nasogastric grohe of supply, were effective for respective average allotted time of 11 and 12 days. This laryngeal partial surgery seem scarce in our practice (12% of the patient who have had it). The improvement of results go to the choice of indications, the information the formation and the acquisition of technical stools more efficient.
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Affiliation(s)
- B K Diallo
- Service d'ORL et de Chirurgie Cervico-Faciale du CHU de Dakar, Sénégal
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Abstract
BACKGROUND Current treatment for most T3 and T4 transglottic and pyriform sinus carcinomas is total laryngectomy or total laryngectomy with partial pharyngectomy. Voice rehabilitation usually requires the use of a tracheoesophageal puncture (TEP). Pearson's near-total laryngectomy (NTL) is an option for voice preservation in selected cases with no invasion of the interarythenoid space and limited invasion of the subglottis. The purpose of this study is to report the functional and survival results of 42 consecutive patients who underwent NTL from 1988 to 1995. Patients and Methods The patients were 40 men and two women, with a median age of 58 years. All patients had squamous cell carcinoma. There were 37 larynx and five pyriform sinus tumors. T3 stage tumor represented 85.7% of the cases. RESULTS There were complications in 13 patients (28.9%). Vocal quality was considered good in 83.3% of the cases. To date, eight patients presented tumor recurrences: two local, two in the neck, and four distant. The 5-year actuarial overall survival rates were of 81.7% in larynx carcinoma and 66.6% in pyriform sinus carcinoma. CONCLUSIONS In selected transglottic and pyriform sinus carcinomas, NTL can be carried out with acceptable morbidity and a high potential of voice preservation and tumor control.
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Affiliation(s)
- R P Andrade
- Head and Neck Surgery Department, Hospital A. C. Camargo, Fundaçao Antônio Prudente, São Paulo, Brazil
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Abstract
AIMS To investigate restoration of the pharynx after total laryngo-pharyngectomy (TLP), one of the major problems in head and neck surgery. METHODS A retrospective analysis of 60 patients undergoing total laryngo-pharyngectomy with gastric transposition was performed between June 1991 and June 1996. The analysis focused on morbidity, mortality and long-term function following gastric transposition. RESULTS The post-operative mortality was 8.3% and the peri-operative morbidity 31.2%. The average hospital stay was 15 days. Immediate restoration of swallowing was achieved in 83% of patients. CONCLUSIONS Gastric transposition after total laryngo-pharyngectomy is a safe procedure and can be performed with low mortality, acceptable morbidity and good long-term function.
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Affiliation(s)
- S B Dudhat
- Tata Memorial Hospital, Parel, Mumbai, India
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13
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Tang P, Tu G, Qi Y. [The extended indications of near-total laryngectomy]. Zhonghua Er Bi Yan Hou Ke Za Zhi 1998; 33:175-7. [PMID: 11717912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
OBJECTIVE To evaluate near-total laryngectomy in treatment of laryngeal cancers. METHODS Fifty-seven near-total laryngectomies were reviewed, among them 40 were T3 or T4 laryngeal cancers due to tumor invasion to the base of tongue or subglottic region. RESULTS In these patients, there were 11 cases of T3 pyriform sinus cancers, 5 cervical esophageal cancers, 1 case with adenoid cystic carcinoma involving the base of the tongue and oropharynx. Speech function had been preserved in 93% of cases with normal swallowing. Three year survival rates were 67.5% in laryngeal cancer and 50% in hypopharyngeal cancer. Local recurrence rate was only 3.5%. CONCLUSION The authors believed that near-total laryngectomy is safe and beneficial to the patients with the above types of cancers. The quality of life may improve if speech function is preserved.
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Affiliation(s)
- P Tang
- Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical University, Beijing 100021
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Laccourreye O, Brasnu D, Périé S, Muscatello L, Ménard M, Weinstein G. Supracricoid partial laryngectomies in the elderly: mortality, complications, and functional outcome. Laryngoscope 1998; 108:237-42. [PMID: 9473075 DOI: 10.1097/00005537-199802000-00015] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A review of the postoperative course, complications, and functional outcome of 69 elderly patients (older than 65 years of age) consecutively managed with a supracricoid partial laryngectomy between 1977 and 1993 is presented. The tumors were glottic and supraglottic in origin in 53 and 16 patients, respectively. A cricohyoidoepiglottopexy, a tracheo-cricohyoidoepiglottopexy, and a cricohyoidopexy were performed in 48, five, and 16 patients, respectively. Immediate laryngeal, cervical, and medical complications were noted in 5.8%, 10.2%, and 10.2% of patients, respectively. Supracricoid partial laryngectomies never resulted in perioperative or postoperative death. The 5-year actuarial survival and local control estimates were 68%, and 93.9%, respectively. Late surgical complications included laryngocele, laryngeal stenosis, and pneumonia from aspiration-related death in 4.3%, 4.3%, and 1.4% of patients, respectively. Completion total laryngectomy, permanent gastrostomy, and permanent tracheostomy were requested in 1.4%, 1.4%, and 2.91% of patients, respectively. Overall a 92.8% laryngeal preservation rate was achieved. Univariate analysis of the potential correlation of different factors with the mortality incidence and causes, the incidence and type of the various complications, and the incidence for postoperative aspiration is presented.
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Affiliation(s)
- O Laccourreye
- Department of Otorhinolaryngology-Head and Neck Surgery, Laënnec Hospital, Assistance Publique des Hôpitaux de Paris, University Paris V, France
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15
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Godey B, Beust L, Cauchin L, Colin L, Le Clec'h G, Bourdinière HJ. [Horizontal subglottic laryngectomy in treating cancers of the laryngeal vestibule and vallecula. Apropos of 65 cases]. Ann Otolaryngol Chir Cervicofac 1996; 113:412-8. [PMID: 9207975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A retrospective review of 65 patients treated with supraglottic laryngectomy from 1980 to 1992 in the Department of Otolaryngology of Rennes was performed. Tumor localisation was vallecula in 38 cases and epiglottis in 27 cases. Functional and carcinologic results are studied for all patients, when base tongue is involved and for patients operated after radiotherapy. The 3 years survival rate was 62,2% and 5 years survival rate 44%. A local failure occurred in 15,4% and 4,6% developed cervical metastasis. Another neoplasm on superior aerodigestive tract is the first cause of death for epiglottis cancer. This data shows that conservative surgery is a higher effective method than radiotherapy for the treatment of small tumors of epiglottis.
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Affiliation(s)
- B Godey
- Service ORL et de Chirurgie Maxillo-faciale, Hôpital de Pontchaillou, CHU, Rennes
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16
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Maurice N, Delol J, Makeieff M, Arnoux A, Crampette L, Guerrier B. [Horizontal supraglottic laryngectomy. Technique, indications, oncologic results and early functional results. Apropos of 87 cases]. Ann Otolaryngol Chir Cervicofac 1996; 113:203-11. [PMID: 9033686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In this article, we advocate supraglottic laryngectomy with bilateral neck dissection for the treatment of supraglottic carcinomas with preserved laryngeal mobility. Post-operative results and follow-up of 87 patients are discussed. This technique allows an excellent loco-regional control of the disease with preservation of laryngeal function. Radiation therapy is preserved for treatment of metachronous (2nd primary) in cases with satisfactory local control without neck metastases. All stage 5-year overall survival rate was 55% with a 68.5% disease survival rate. Five-year local control of the disease and regional control of neck nodes were respectively 94% and 92%. Five-year disease survival rate for N- population was 71% Vs 61% for N+ population. Five-year disease survival rate according to the tumor classification was 70% for T1, 75% for T2, 69% for T3 and 54% for T4. In the post-operative follow-up, the median of time to decanulation was 17 days, that of nasogastric tube removal was 19 days, that of hospital stay 38 days.
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Affiliation(s)
- N Maurice
- Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, Hôpital St-Charles, Montpellier
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17
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Germain MA, Trotoux J, Luboinski B, Wibault P, Demers G. [Reconstruction by free jejunal transplant after circular pharyngolaryngectomy (functional results and survival)]. Bull Acad Natl Med 1995; 179:147-56; discussion 156-7. [PMID: 7788441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
One hundred and ninety seven patients with cancer of the hypopharynx underwent after circular resection, reconstruction with a free jejunal graft. The quality of free jejunal grafts is controlled by many investigations: clinical examination, radiography, electromyography, fibroscopy with biopsy. These investigations show that technically jejunal grafts must be short and linear to give the best functional results. Average resumption of oral intake was 14 days. Oral feeding was possible in 92% of cases. The free jejunal grafts with microsurgery are one of the more reliable procedures for reconstruction of pharynx and cervical esophagus after resection for cancer. (2 post-operative deaths and 8 grafts necrosis on 197 cases). The cumulative survival rate of 5 years was 35% for free jejunal graft. Survival depends on selection of the patients for local and nodes invasion. The quality of survival has improved. This operation must be reserved for the hypopharyngeal cancers which need a circular resection and do not invade the esophagus. The surgery is performed for a curative aim. The distant follow up of the patients is imperative: consultation every four months and then every six months: clinical examination, endoscopic, E.N.T., bronchial, and esophageal investigation. Chemotherapy and radiotherapy have specific indications.
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Affiliation(s)
- M A Germain
- Service de Chirurgie, Hôpital Max Fourestier, Nanterre
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18
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Lont HE, van Lanschot JJ, Hop WC, Eijkenboom WM, Knegt PP, Tilanus HW. [Reconstruction of the digestive tract using a free small intestine interpositional graft following total larynx-pharynx extirpation. Follow-up results]. Ned Tijdschr Geneeskd 1994; 138:1317-21. [PMID: 8028676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To evaluate the results of pharyngo-oesophageal reconstruction after pharyngolaryngectomy using a free jejunal interposition graft. DESIGN Retrospective study. SETTING University Hospital Dijkzigt, Rotterdam. PATIENTS AND METHODS Between 1982 and 1992, 59 selected patients (median age 63 years) undergoing laryngopharyngectomy for cancer had the continuity of the upper gastrointestinal tract restored by use of a free jejunal autograft. Twenty-three (36%) had had no previous treatment and received post-operative radiotherapy. Eight patients had laryngeal tumour recurrence after irradiation and in 28 (48%) patients pre-operative radiotherapy had been administered. RESULTS Follow-up ranged from 1-127 months (mean 37 months). Graft necrosis secondary to vascular problems initially occurred in 5 patients. In four cases the jejunum was successfully replaced by another segment and in one patient a gastric transposition was performed. Fistulas occurred in eight patients of whom four required surgery. The mortality rate was 8.5%. After discharge 6 patients were reoperated on for dysphagia due to stricture formation. In four cases the distal or proximal anastomosis was revised and in the other two patients the graft was replaced, by another segment and by a colonic autograft, respectively. One year after operation 85% of the patients reported an adequate swallowing function and a normal oral intake. The overall 5-year survival rate of this selected group of patients was 42%, for those without primary lymph node involvement 66%. All patients with primary locoregional metastasis died within a period of 34 months after operation. CONCLUSION Reconstruction of the upper alimentary tract after a laryngopharyngectomy with a free jejunal autograft appears to be a relatively safe procedure with an acceptable mortality and morbidity and, in patients without local lymph node involvement, good long-term results.
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Affiliation(s)
- H E Lont
- Afd. Algemene Heelkunde, Academisch Ziekenhuis Rotterdam-Dijkzigt
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19
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Chevalier D, Thill C, Darras JA, Piquet JJ. [Results of the surgical treatment of cancers of the supraglottic area]. Ann Otolaryngol Chir Cervicofac 1993; 110:147-151. [PMID: 8239335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The authors report a retrospective analysis of the results of surgery in 169 patients with supraglottic cancer referred to the Lille ENT clinic from 1976 to 1985. Partial surgery was performed in 53% of patients versus total laryngectomy in 47%. The 5 year survival rates in the patient groups treated by supraglottic laryngectomy and supracricoid laryngectomy with cricohyoidopexy were similar, 69.4% and 75.2%, respectively. The 5 year survival rate in the patient group treated by total laryngectomy or by total laryngectomy extended to the base of tongue was 62.8%.
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Affiliation(s)
- D Chevalier
- Service d'ORL, Hôpital Claude Huriez, CHU de Lille
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20
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Affiliation(s)
- C Calearo
- ENT Department, University of Ferrara, Italy
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21
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Abstract
A series of 478 patients with T1-3N0 glottic carcinoma treated by irradiation is presented. Of these patients, 320 were previously untreated, whereas 158 patients were referred for treatment of a recurrence after receiving radiotherapy elsewhere. The primary recurrence rate in the previously untreated patients was 10%. The rate was higher in T2 and T3 tumors, poorly differentiated tumors, and in patients who were in poor general condition. Over 80% of the recurrent tumors were Stage pT3 or pT4, whereas 12% of total laryngectomy specimens showed necrosis only with no evidence of tumor. The necrosis rate in previously untreated patients was 1% for T1 tumors, 4% for T2 tumors, and 3% for T3 tumors. Of all tumors, 60% were transglottic when they recurred, whereas only 29% were confined to the glottis at recurrence. Histologic diagnosis had a high sensitivity but a low specificity, indicating that a negative histologic report is unreliable. Of patients with a recurrent primary tumor, 13% were untreatable. The 5-year survival after a primary recurrence was 39%, and the main prognostic factors were sex, T stage at recurrence, and time to recurrence. Of patients available for follow-up at 5 years 49% were alive with a larynx, 5% were alive without a larynx, 13% were dead of the original cancer, and 33% had died of other causes. In those suffering a primary recurrence, the commonest cause of death was a subsequent lymph node metastasis, followed in order of frequency by stomal recurrence and recurrence in the pharyngeal remnant. The hospital mortality rate after laryngectomy was 3%, and 30% of patients undergoing laryngectomy developed a pharyngocutaneous fistula. The recurrence rate in lymph nodes was 14% at 5 years, general condition and T stage being the only significant predictors of recurrence. Only 17% of patients had small (N1) nodes by the time the diagnosis of cervical lymph node recurrence was made, and 27% of all patients were unsuitable for treatment. Host, tumor factors, and time to recurrence were not significant predictors of survival after node recurrence. The survival rate 5 years after node recurrence was 16%, and the main cause of death in those who died was uncontrolled disease in the neck. The hospital mortality after salvage neck dissection was 4.7%.
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Affiliation(s)
- L Viani
- Department of Otorhinolaryngology, University of Liverpool, England
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22
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Abstract
The prevention and management of medical complications are important components in the surgical treatment of head and neck malignancies. We retrospectively evaluated the postoperative medical complications in 414 patients who underwent total laryngectomy between 1973 and 1987. The mortality rate was 1.2% (five deaths); while major, nonfatal medical complications occurred in 6.3% (24 of 384 patients)--seven strokes, three myocardial infarctions, two pulmonary emboli, and 12 respiratory failures requiring mechanical ventilation. Elderly patients did not experience more frequent or more severe medical complications, and the overall pattern of complications was different from that of other surgical specialties. Only specific cardiovascular and pulmonary risk factors were associated with these complications. We conclude that medical complications are a significant cause of morbidity in total laryngectomy; a focused preanesthetic risk factor analysis by a medical team familiar with head and neck cancer patients assures prompt identification and management of these complications.
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Affiliation(s)
- M A Arriaga
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pennsylvania
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Soo KC, Shah JP, Gopinath KS, Jaques DP, Gerold FP, Strong EW. Analysis of prognostic variables and results after vertical partial laryngectomy. Am J Surg 1988; 156:264-8. [PMID: 3177747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A consecutive series of 197 patients who underwent conservation surgery for squamous cell carcinoma of the glottic larynx was analyzed. The majority of patients were male. One hundred forty-one had stage I disease, 44 had stage II, and 12 had stage III disease at the time of treatment. Partial laryngectomy was performed in 25 patients who had recurrent cancer after previous definitive radiotherapy and in 5 patients who had previously undergone cordectomy. There was no operative mortality and postoperative morbidity was low. Local recurrence developed in 32 patients (17 percent); cervical metastasis developed in 8 patients. The determinate survival rates at 3 and 5 years were 92 percent and 87 percent, respectively. Multivariate analysis showed soft-tissue margins and tumor differentiation as the two significant covariates in predicting survival. Positive surgical margins were also significant covariates affecting local recurrence. These data suggest that conservation surgery is an effective treatment for early vocal cord carcinoma. Adequate surgical margins are essential. Postoperative irradiation should be considered in patients with inadequate margins.
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Affiliation(s)
- K C Soo
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
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24
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Soo KC, Shah JP, Gopinath KS, Gerold FP, Jaques DP, Strong EW. Analysis of prognostic variables and results after supraglottic partial laryngectomy. Am J Surg 1988; 156:301-5. [PMID: 3177756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A consecutive series of 78 patients who underwent conservation surgery for squamous cell carcinoma of the supraglottic larynx is analyzed. The majority of the patients were middle-aged men who had early-stage disease, with only 18 patients in stage III and 6 in stage IV. The epiglottis was the most frequent site, followed by the aryepiglottic fold and other sites in the supraglottic larynx. There was no operative mortality and the complication rate was low. Univariate analysis showed no influence of tumor stage, tumor differentiation, or involved surgical margins on survival. Determinate survival rates of 85 percent at 3 years and 72 percent at 5 years were observed. Local recurrences took place in 12 patients, 4 of whom were salvaged by total laryngectomy; neck failure occurred in 13 patients, 7 of whom were salvaged after further treatment; and 1 of the 2 patients with distant metastasis was salvaged after further treatment. We believe that every patient with a favorable lesion of the supraglottic larynx should be considered for conservation surgery, specifically, supraglottic partial laryngectomy, adhering to the criteria mentioned. Initial surgical treatment offers excellent local control and 5 year survival. Adjuvant postoperative radiotherapy may be considered in those patients with bulky primary tumors, positive surgical margins, and histologically confirmed cervical lymph node metastases.
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Affiliation(s)
- K C Soo
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
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25
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Brasnu D, Menard M, Fabre A, Janot F, Laccourreye H. [Partial supracricoid laryngectomies: techniques, indications and results]. J Otolaryngol 1988; 17:173-8. [PMID: 3398106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The authors present results of a retrospective study on 99 patients who underwent a partial supracricoid laryngectomy. Indications included carcinomas developed on the laryngeal vestibule, in the ventricle or at the glottic level. This represents an alternative to total laryngectomy. Surgical techniques and functional results are discussed. Ninety-eight percent of patients could be decanulated and a regular diet was possible in 94%. The survival rates are 76% after three years and 68% after five years. Local recurrences occurred in 3% of cases and cervical metastases were not controlled in 13%. The authors comment on indications for surgery according to the site of involvement. Contra-indications are massive invasion of the pre-epiglottic space, extension away from the superior aspect of the cricoid and arytenoid fixation.
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Affiliation(s)
- D Brasnu
- Université René Descartes, Paris, France
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26
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Affiliation(s)
- V C Cousins
- Institute of Laryngology and Otology and Royal National Throat, Nose and Ear Hospital, London, UK
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27
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Abstract
A supraglottic laryngectomy offers the possibility of resection of a large portion of the larynx leaving the true vocal cords. From 57 supraglottic laryngectomies performed between 1971 and 1984 in the Department of Otolaryngology and Head and Neck Surgery of the University of Nijmegen, the 5- and 10-year actuarial survival rates were 80% and 59%, respectively. The deaths after 5 years were not directly related to the original tumour. The functional results with respect to the voice were excellent. In this study particular attention has been paid to the postoperative results with regard to swallowing and aspiration. More than half of the patients (56%) had occasional complaints of aspiration, especially when taking liquids. It is concluded that supraglottic laryngectomy is an excellent alternative, especially for the treatment of extensive supraglottic tumours without involvement of the true vocal cords.
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Affiliation(s)
- M Strijbos
- Department of Otorhinolaryngology, University Hospital Nijmegen, The Netherlands
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29
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Hayakawa K, Mitsuhashi N, Ikeda H, Tamaki Y, Yamakawa M, Takahashi M, Matsuura M, Niibe H. [Radiation therapy of early glottic cancer]. Nihon Gan Chiryo Gakkai Shi 1984; 19:2069-74. [PMID: 6442335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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30
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Morton RP, Stell PM. Supraglottic laryngectomy: a perspective for New Zealand. Aust N Z J Surg 1984; 54:63-6. [PMID: 6586170 DOI: 10.1111/j.1445-2197.1984.tb06687.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A series of 794 patients with laryngeal cancer in Liverpool from 1965 to 1983 were reviewed with particular reference to the results after supraglottic laryngectomy. The results indicated that radiotherapy is to be preferred for T1N0 supraglottic tumours, and supraglottic laryngectomy is indicated only for patients with small primary tumours, and clinically involved lymph nodes. On comparing 274 patients with laryngeal cancer from Auckland, seen over a similar period (1965-1979), it is clear that even fewer patients than in Liverpool, both absolutely and relatively, would be eligible for supraglottic laryngectomy in New Zealand. In view of the reportedly high morbidity and mortality associated with the operation, one may question the wisdom of performing supraglottic laryngectomy in New Zealand, where suitable patients are rare.
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Watanabe H, Komiyama S, Tomita K, Jinguh K. [Partial laryngectomy following combined FAR therapy--evaluation of survival rate and region of recurrence studied by an antomical map]. Gan No Rinsho 1983; 29:945-8. [PMID: 6620572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The clinical records of 75 consecutive patients undergoing partial laryngectomy at Kyushu University Hospital were reviewed. Almost all the patients were treated by combined preoperative FAR therapy (5 FU, vitamin A and irradiation). Among 57 patients, the (estimated) five year survival rate was 76%. The cure rate among 18 patients in whom horizontal laryngectomy was done was high (75%) compared with results presented in other reports. This may be ascribable to the preoperative FAR therapy. Anatomically, critical regions of recurrence were the subglottic region and anterior commissure in vertical partial laryngectomy.
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Abstract
Fifty-three patients had pharyngolaryngoesophagectomy during the years 1965 to 1976 for lower hypopharyngeal or cervical esophageal cancer. The operative mortality--defined as the percent of patients who died within seven days of operation--was 7.5%, which is reduced to 5.6% if one patient with inoperable disease is excluded. Twenty-eight percent of patients survived for longer than one year, and there have been no problems with swallowing. Communication is possible in every patient who possesses good motivation, but the problems of long-term management of calcium metabolism still require attention.
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34
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Sellars SL, Jarvis JF. The mortality and morbidity of laryngectomy. S Afr Med J 1976; 50:428-31. [PMID: 1265539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Experiences with 147 laryngectomies, 49 with en bloc neck dissection, are presented. One patient died, and 36 suffered postoperative complications serious enough to delay rehabilitation and to prolong hospitalisation.
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35
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36
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André P, Laccourreye H, Haguet JF. [Long-term results of surgical treatment for cancer of the larynx]. Ann Otolaryngol Chir Cervicofac 1974; 91:13-20. [PMID: 4849119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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37
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King PS, Lewis FR, Weddle JL, Fowlks EW. Effect of radical neck dissection on total rehabilitation of the laryngectomee. Am J Phys Med 1973; 52:1-17. [PMID: 4685520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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38
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Martin H, Gignoux B, Gadot P, Maitrejean Y. [Statistics on 10 years of treatment of piriform sinus cancer]. Ann Otolaryngol Chir Cervicofac 1973; 90:111-6. [PMID: 4723748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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39
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40
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Ogura JH, Biller HF. [Partial laryngectomy]. Arch Klin Exp Ohren Nasen Kehlkopfheilkd 1969; 194:339-51. [PMID: 5372600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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41
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Molinari R, Zingo L, Zappata A. [Evaluation of usefulness of radical neck dissection by total laryngectomy for intrinsic laryngeal carcinoma]. Clin Otorinolaringoiatr 1969; 21:389-410. [PMID: 5401853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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42
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43
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Vadura F. [Evaluation of therapeutic results in laryngeal carcinoma]. Strahlentherapie 1966; 130:489-94. [PMID: 5996850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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