Treatment Selection for T3/T4a Laryngeal Cancer: Chemoradiation Versus Primary Surgery
Objective: We report the treatment outcomes, including organ preservation, for patients with locally advanced (T3/T4a) laryngeal cancer receiving both surgical and nonsurgical approaches. We hypothesize that selection of treatment protocols aimed to optimize organ preservation does not compromise su...
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| Veröffentlicht in: | Annals of otology, rhinology & laryngology rhinology & laryngology, 2015-11, Vol.124 (11), p.845-851 |
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| container_title | Annals of otology, rhinology & laryngology |
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| creator | Timme, David W. Jonnalagadda, Sashikanth Patel, Raunak Rao, Krishna Robbins, K. Thomas |
| description | Objective:
We report the treatment outcomes, including organ preservation, for patients with locally advanced (T3/T4a) laryngeal cancer receiving both surgical and nonsurgical approaches. We hypothesize that selection of treatment protocols aimed to optimize organ preservation does not compromise survival provided careful selection is done through the process of multidisciplinary treatment planning.
Methods:
Patients with T3-4a laryngeal squamous cell cancer were evaluated and recommended for primary treatment with total or partial laryngectomy (37 patients) or chemoradiotherapy (34 patients). Treatment outcomes were compared between the 2 cohorts. In addition, the laryngeal preservation rate and laryngoesophageal dysfunction-free survival (LEDFS) were determined for the chemoradiation group.
Results:
The 5-year overall survival rate for patients with T3 lesions was 41% and 40% for the surgical and nonsurgical groups, respectively, and for T4 lesions it was 54% and 53%, respectively. For the chemoradiation group, the rate of overall laryngeal preservation was 79%. LEDFS at 2 years was 40% for T3 lesions and 33% for T4 lesions.
Conclusion:
Through careful selection, some patients with locally advanced laryngeal cancer can be offered chemoradiation (organ preservation) without compromising survival. However, the patients selected to receive chemoradiation have a high rate of laryngeal and esophageal dysfunction. |
| doi_str_mv | 10.1177/0003489415588130 |
| format | Article |
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We report the treatment outcomes, including organ preservation, for patients with locally advanced (T3/T4a) laryngeal cancer receiving both surgical and nonsurgical approaches. We hypothesize that selection of treatment protocols aimed to optimize organ preservation does not compromise survival provided careful selection is done through the process of multidisciplinary treatment planning.
Methods:
Patients with T3-4a laryngeal squamous cell cancer were evaluated and recommended for primary treatment with total or partial laryngectomy (37 patients) or chemoradiotherapy (34 patients). Treatment outcomes were compared between the 2 cohorts. In addition, the laryngeal preservation rate and laryngoesophageal dysfunction-free survival (LEDFS) were determined for the chemoradiation group.
Results:
The 5-year overall survival rate for patients with T3 lesions was 41% and 40% for the surgical and nonsurgical groups, respectively, and for T4 lesions it was 54% and 53%, respectively. For the chemoradiation group, the rate of overall laryngeal preservation was 79%. LEDFS at 2 years was 40% for T3 lesions and 33% for T4 lesions.
Conclusion:
Through careful selection, some patients with locally advanced laryngeal cancer can be offered chemoradiation (organ preservation) without compromising survival. However, the patients selected to receive chemoradiation have a high rate of laryngeal and esophageal dysfunction.</description><identifier>ISSN: 0003-4894</identifier><identifier>EISSN: 1943-572X</identifier><identifier>DOI: 10.1177/0003489415588130</identifier><identifier>PMID: 25991835</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Carcinoma, Squamous Cell - drug therapy ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - surgery ; Chemoradiotherapy - methods ; Chemoradiotherapy - statistics & numerical data ; Female ; Head and Neck Neoplasms - drug therapy ; Head and Neck Neoplasms - mortality ; Head and Neck Neoplasms - pathology ; Head and Neck Neoplasms - surgery ; Humans ; Illinois ; Laryngeal Neoplasms - drug therapy ; Laryngeal Neoplasms - mortality ; Laryngeal Neoplasms - pathology ; Laryngeal Neoplasms - surgery ; Laryngectomy - methods ; Laryngectomy - statistics & numerical data ; Male ; Middle Aged ; Neck Dissection - methods ; Neck Dissection - statistics & numerical data ; Neoplasm Staging ; Patient Selection ; Retrospective Studies ; Squamous Cell Carcinoma of Head and Neck ; Survival Rate ; Treatment Outcome</subject><ispartof>Annals of otology, rhinology & laryngology, 2015-11, Vol.124 (11), p.845-851</ispartof><rights>The Author(s) 2015</rights><rights>The Author(s) 2015.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c290t-45c3fbcebfd4a15df2a6873c4434b44d110684a4b2ce01ad081e51090399e76d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0003489415588130$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0003489415588130$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25991835$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Timme, David W.</creatorcontrib><creatorcontrib>Jonnalagadda, Sashikanth</creatorcontrib><creatorcontrib>Patel, Raunak</creatorcontrib><creatorcontrib>Rao, Krishna</creatorcontrib><creatorcontrib>Robbins, K. Thomas</creatorcontrib><title>Treatment Selection for T3/T4a Laryngeal Cancer: Chemoradiation Versus Primary Surgery</title><title>Annals of otology, rhinology & laryngology</title><addtitle>Ann Otol Rhinol Laryngol</addtitle><description>Objective:
We report the treatment outcomes, including organ preservation, for patients with locally advanced (T3/T4a) laryngeal cancer receiving both surgical and nonsurgical approaches. We hypothesize that selection of treatment protocols aimed to optimize organ preservation does not compromise survival provided careful selection is done through the process of multidisciplinary treatment planning.
Methods:
Patients with T3-4a laryngeal squamous cell cancer were evaluated and recommended for primary treatment with total or partial laryngectomy (37 patients) or chemoradiotherapy (34 patients). Treatment outcomes were compared between the 2 cohorts. In addition, the laryngeal preservation rate and laryngoesophageal dysfunction-free survival (LEDFS) were determined for the chemoradiation group.
Results:
The 5-year overall survival rate for patients with T3 lesions was 41% and 40% for the surgical and nonsurgical groups, respectively, and for T4 lesions it was 54% and 53%, respectively. For the chemoradiation group, the rate of overall laryngeal preservation was 79%. LEDFS at 2 years was 40% for T3 lesions and 33% for T4 lesions.
Conclusion:
Through careful selection, some patients with locally advanced laryngeal cancer can be offered chemoradiation (organ preservation) without compromising survival. However, the patients selected to receive chemoradiation have a high rate of laryngeal and esophageal dysfunction.</description><subject>Aged</subject><subject>Carcinoma, Squamous Cell - drug therapy</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>Chemoradiotherapy - methods</subject><subject>Chemoradiotherapy - statistics & numerical data</subject><subject>Female</subject><subject>Head and Neck Neoplasms - drug therapy</subject><subject>Head and Neck Neoplasms - mortality</subject><subject>Head and Neck Neoplasms - pathology</subject><subject>Head and Neck Neoplasms - surgery</subject><subject>Humans</subject><subject>Illinois</subject><subject>Laryngeal Neoplasms - drug therapy</subject><subject>Laryngeal Neoplasms - mortality</subject><subject>Laryngeal Neoplasms - pathology</subject><subject>Laryngeal Neoplasms - surgery</subject><subject>Laryngectomy - methods</subject><subject>Laryngectomy - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neck Dissection - methods</subject><subject>Neck Dissection - statistics & numerical data</subject><subject>Neoplasm Staging</subject><subject>Patient Selection</subject><subject>Retrospective Studies</subject><subject>Squamous Cell Carcinoma of Head and Neck</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0003-4894</issn><issn>1943-572X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kL1PwzAQxS0EoqWwM6GMLKE--5zYI6r4kiIxECS2yHEuVat8FDsZ-O9J1cKAxHQ6vd97unuMXQO_A0jTJedcojYISmkNkp-wORiUsUrFxymb7-V4r8_YRQjbaUXFxTmbCWUMaKnmbJl7skNL3RC9UUNu2PRdVPc-yuUyRxtl1n91a7JNtLKdI3_JzmrbBLo6zgV7f3zIV89x9vr0srrPYicMH2JUTtalo7Ku0IKqamETnUqHKLFErAB4otFiKRxxsBXXQAq44dIYSpNKLtjtIXfn-8-RwlC0m-CoaWxH_RgKSIUAnaDSE8oPqPN9CJ7qYuc37XR3AbzY11T8rWmy3BzTx7Kl6tfw08sExAcg2DUV23703fTt_4HfvyFssg</recordid><startdate>201511</startdate><enddate>201511</enddate><creator>Timme, David W.</creator><creator>Jonnalagadda, Sashikanth</creator><creator>Patel, Raunak</creator><creator>Rao, Krishna</creator><creator>Robbins, K. Thomas</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>8BM</scope></search><sort><creationdate>201511</creationdate><title>Treatment Selection for T3/T4a Laryngeal Cancer</title><author>Timme, David W. ; Jonnalagadda, Sashikanth ; Patel, Raunak ; Rao, Krishna ; Robbins, K. Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c290t-45c3fbcebfd4a15df2a6873c4434b44d110684a4b2ce01ad081e51090399e76d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Carcinoma, Squamous Cell - drug therapy</topic><topic>Carcinoma, Squamous Cell - mortality</topic><topic>Carcinoma, Squamous Cell - pathology</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>Chemoradiotherapy - methods</topic><topic>Chemoradiotherapy - statistics & numerical data</topic><topic>Female</topic><topic>Head and Neck Neoplasms - drug therapy</topic><topic>Head and Neck Neoplasms - mortality</topic><topic>Head and Neck Neoplasms - pathology</topic><topic>Head and Neck Neoplasms - surgery</topic><topic>Humans</topic><topic>Illinois</topic><topic>Laryngeal Neoplasms - drug therapy</topic><topic>Laryngeal Neoplasms - mortality</topic><topic>Laryngeal Neoplasms - pathology</topic><topic>Laryngeal Neoplasms - surgery</topic><topic>Laryngectomy - methods</topic><topic>Laryngectomy - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neck Dissection - methods</topic><topic>Neck Dissection - statistics & numerical data</topic><topic>Neoplasm Staging</topic><topic>Patient Selection</topic><topic>Retrospective Studies</topic><topic>Squamous Cell Carcinoma of Head and Neck</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Timme, David W.</creatorcontrib><creatorcontrib>Jonnalagadda, Sashikanth</creatorcontrib><creatorcontrib>Patel, Raunak</creatorcontrib><creatorcontrib>Rao, Krishna</creatorcontrib><creatorcontrib>Robbins, K. Thomas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>ComDisDome</collection><jtitle>Annals of otology, rhinology & laryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Timme, David W.</au><au>Jonnalagadda, Sashikanth</au><au>Patel, Raunak</au><au>Rao, Krishna</au><au>Robbins, K. Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment Selection for T3/T4a Laryngeal Cancer: Chemoradiation Versus Primary Surgery</atitle><jtitle>Annals of otology, rhinology & laryngology</jtitle><addtitle>Ann Otol Rhinol Laryngol</addtitle><date>2015-11</date><risdate>2015</risdate><volume>124</volume><issue>11</issue><spage>845</spage><epage>851</epage><pages>845-851</pages><issn>0003-4894</issn><eissn>1943-572X</eissn><abstract>Objective:
We report the treatment outcomes, including organ preservation, for patients with locally advanced (T3/T4a) laryngeal cancer receiving both surgical and nonsurgical approaches. We hypothesize that selection of treatment protocols aimed to optimize organ preservation does not compromise survival provided careful selection is done through the process of multidisciplinary treatment planning.
Methods:
Patients with T3-4a laryngeal squamous cell cancer were evaluated and recommended for primary treatment with total or partial laryngectomy (37 patients) or chemoradiotherapy (34 patients). Treatment outcomes were compared between the 2 cohorts. In addition, the laryngeal preservation rate and laryngoesophageal dysfunction-free survival (LEDFS) were determined for the chemoradiation group.
Results:
The 5-year overall survival rate for patients with T3 lesions was 41% and 40% for the surgical and nonsurgical groups, respectively, and for T4 lesions it was 54% and 53%, respectively. For the chemoradiation group, the rate of overall laryngeal preservation was 79%. LEDFS at 2 years was 40% for T3 lesions and 33% for T4 lesions.
Conclusion:
Through careful selection, some patients with locally advanced laryngeal cancer can be offered chemoradiation (organ preservation) without compromising survival. However, the patients selected to receive chemoradiation have a high rate of laryngeal and esophageal dysfunction.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>25991835</pmid><doi>10.1177/0003489415588130</doi><tpages>7</tpages></addata></record> |
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| subjects | Aged Carcinoma, Squamous Cell - drug therapy Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - surgery Chemoradiotherapy - methods Chemoradiotherapy - statistics & numerical data Female Head and Neck Neoplasms - drug therapy Head and Neck Neoplasms - mortality Head and Neck Neoplasms - pathology Head and Neck Neoplasms - surgery Humans Illinois Laryngeal Neoplasms - drug therapy Laryngeal Neoplasms - mortality Laryngeal Neoplasms - pathology Laryngeal Neoplasms - surgery Laryngectomy - methods Laryngectomy - statistics & numerical data Male Middle Aged Neck Dissection - methods Neck Dissection - statistics & numerical data Neoplasm Staging Patient Selection Retrospective Studies Squamous Cell Carcinoma of Head and Neck Survival Rate Treatment Outcome |
| title | Treatment Selection for T3/T4a Laryngeal Cancer: Chemoradiation Versus Primary Surgery |
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