Salvage total laryngectomy after external-beam radiotherapy: A 20-year experience
Background The purpose of this study was to present our evaluation of the clinical and functional outcomes after salvage total laryngectomy (STL). Methods We conducted a retrospective review of 218 patients who underwent STL between 1994 and 2014. Results Seventy percent of patients originally had T...
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| Veröffentlicht in: | Head & neck 2016-04, Vol.38 (S1), p.E1962-E1968 |
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| creator | Sandulache, Vlad C. Vandelaar, Laura J. Skinner, Heath D. Cata, Juan Hutcheson, katherine Fuller, Clifton David Phan, Jack Siddiqui, Zuhair Lai, Stephen Y. Weber, Randal S. Zafereo, Mark E. |
| description | Background
The purpose of this study was to present our evaluation of the clinical and functional outcomes after salvage total laryngectomy (STL).
Methods
We conducted a retrospective review of 218 patients who underwent STL between 1994 and 2014.
Results
Seventy percent of patients originally had T1 or T2, N0 tumors and 73% had definitive external‐beam radiotherapy (EBRT) alone. A majority utilized tracheoesophageal prosthesis (77%) and were gastrostomy free (80%) at last follow‐up. The 5‐year disease control and overall survival (OS) rates were 65% and 57%, respectively. Patients with a disease‐free interval after initial treatment 5‐year disease‐free interval and 60% for |
| doi_str_mv | 10.1002/hed.24355 |
| format | Article |
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The purpose of this study was to present our evaluation of the clinical and functional outcomes after salvage total laryngectomy (STL).
Methods
We conducted a retrospective review of 218 patients who underwent STL between 1994 and 2014.
Results
Seventy percent of patients originally had T1 or T2, N0 tumors and 73% had definitive external‐beam radiotherapy (EBRT) alone. A majority utilized tracheoesophageal prosthesis (77%) and were gastrostomy free (80%) at last follow‐up. The 5‐year disease control and overall survival (OS) rates were 65% and 57%, respectively. Patients with a disease‐free interval after initial treatment <2 years were more likely to develop a recurrence (p = .001) and die of disease (p = .032) after STL. The disease‐free interval after EBRT impacted disease control (p < .001), with 5‐year disease control of 92% for >5‐year disease‐free interval and 60% for <2‐year disease‐free interval.
Conclusion
Most patients remain disease‐free after STL, achieve intelligible tracheoesophageal speech, and maintain an oral diet. Delayed recurrence after initial treatment portends better survival and may indicate a distinct biological profile. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1962–E1968, 2016</description><identifier>ISSN: 1043-3074</identifier><identifier>EISSN: 1097-0347</identifier><identifier>DOI: 10.1002/hed.24355</identifier><identifier>PMID: 26879395</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell - radiotherapy ; Carcinoma, Squamous Cell - surgery ; complications ; disease-free interval ; Disease-Free Survival ; Female ; fistula ; Follow-Up Studies ; free flap ; Humans ; Laryngeal Neoplasms - radiotherapy ; Laryngeal Neoplasms - surgery ; Laryngectomy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; radiotherapy ; recurrence ; Retrospective Studies ; salvage ; Salvage Therapy ; squamous cell carcinoma ; Survival Rate</subject><ispartof>Head & neck, 2016-04, Vol.38 (S1), p.E1962-E1968</ispartof><rights>2016 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3985-9aa866b404a8f9949b47f17a114bf99fbfda61fb8a28818d7ddd4948c6755e093</citedby><cites>FETCH-LOGICAL-c3985-9aa866b404a8f9949b47f17a114bf99fbfda61fb8a28818d7ddd4948c6755e093</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhed.24355$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhed.24355$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26879395$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sandulache, Vlad C.</creatorcontrib><creatorcontrib>Vandelaar, Laura J.</creatorcontrib><creatorcontrib>Skinner, Heath D.</creatorcontrib><creatorcontrib>Cata, Juan</creatorcontrib><creatorcontrib>Hutcheson, katherine</creatorcontrib><creatorcontrib>Fuller, Clifton David</creatorcontrib><creatorcontrib>Phan, Jack</creatorcontrib><creatorcontrib>Siddiqui, Zuhair</creatorcontrib><creatorcontrib>Lai, Stephen Y.</creatorcontrib><creatorcontrib>Weber, Randal S.</creatorcontrib><creatorcontrib>Zafereo, Mark E.</creatorcontrib><title>Salvage total laryngectomy after external-beam radiotherapy: A 20-year experience</title><title>Head & neck</title><addtitle>Head Neck</addtitle><description>Background
The purpose of this study was to present our evaluation of the clinical and functional outcomes after salvage total laryngectomy (STL).
Methods
We conducted a retrospective review of 218 patients who underwent STL between 1994 and 2014.
Results
Seventy percent of patients originally had T1 or T2, N0 tumors and 73% had definitive external‐beam radiotherapy (EBRT) alone. A majority utilized tracheoesophageal prosthesis (77%) and were gastrostomy free (80%) at last follow‐up. The 5‐year disease control and overall survival (OS) rates were 65% and 57%, respectively. Patients with a disease‐free interval after initial treatment <2 years were more likely to develop a recurrence (p = .001) and die of disease (p = .032) after STL. The disease‐free interval after EBRT impacted disease control (p < .001), with 5‐year disease control of 92% for >5‐year disease‐free interval and 60% for <2‐year disease‐free interval.
Conclusion
Most patients remain disease‐free after STL, achieve intelligible tracheoesophageal speech, and maintain an oral diet. Delayed recurrence after initial treatment portends better survival and may indicate a distinct biological profile. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1962–E1968, 2016</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Squamous Cell - radiotherapy</subject><subject>Carcinoma, Squamous Cell - surgery</subject><subject>complications</subject><subject>disease-free interval</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>fistula</subject><subject>Follow-Up Studies</subject><subject>free flap</subject><subject>Humans</subject><subject>Laryngeal Neoplasms - radiotherapy</subject><subject>Laryngeal Neoplasms - surgery</subject><subject>Laryngectomy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local</subject><subject>radiotherapy</subject><subject>recurrence</subject><subject>Retrospective Studies</subject><subject>salvage</subject><subject>Salvage Therapy</subject><subject>squamous cell carcinoma</subject><subject>Survival Rate</subject><issn>1043-3074</issn><issn>1097-0347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtOwzAQRS0E4r3gB1CWsEhrx3Zss0OlFMRLiAJLa5JMIJA0xU6B_D0pbdmxmZfOvdJcQg4Y7TFKo_4rZr1IcCnXyDajRoWUC7U-nwUPOVVii-x4_0Yp5bGINslWFGtluJHb5P4Byk94waCpGyiDElw7ecG0qas2gLxBF-B3VydQhglCFTjIirp5RQfT9iQ4DSIatghzaoquwEmKe2Qjh9Lj_rLvksfz4XhwEV7fjS4Hp9dhyo2WoQHQcZwIKkDnxgiTCJUzBYyJpNvzJM8gZnmiIdKa6UxlWSaM0GmspERq-C45WvhOXf0xQ9_YqvApliVMsJ55y5QWSsiYRh16vEBTV3vvMLdTV1Tdq5ZRO0_Qdgna3wQ79nBpO0uq7roiV5F1QH8BfBUltv872Yvh2coyXCgK3-D3nwLcu40VV9I-346subli43t5ZZ_4DzbyiTw</recordid><startdate>201604</startdate><enddate>201604</enddate><creator>Sandulache, Vlad C.</creator><creator>Vandelaar, Laura J.</creator><creator>Skinner, Heath D.</creator><creator>Cata, Juan</creator><creator>Hutcheson, katherine</creator><creator>Fuller, Clifton David</creator><creator>Phan, Jack</creator><creator>Siddiqui, Zuhair</creator><creator>Lai, Stephen Y.</creator><creator>Weber, Randal S.</creator><creator>Zafereo, Mark E.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><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></search><sort><creationdate>201604</creationdate><title>Salvage total laryngectomy after external-beam radiotherapy: A 20-year experience</title><author>Sandulache, Vlad C. ; Vandelaar, Laura J. ; Skinner, Heath D. ; Cata, Juan ; Hutcheson, katherine ; Fuller, Clifton David ; Phan, Jack ; Siddiqui, Zuhair ; Lai, Stephen Y. ; Weber, Randal S. ; Zafereo, Mark E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3985-9aa866b404a8f9949b47f17a114bf99fbfda61fb8a28818d7ddd4948c6755e093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Squamous Cell - radiotherapy</topic><topic>Carcinoma, Squamous Cell - surgery</topic><topic>complications</topic><topic>disease-free interval</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>fistula</topic><topic>Follow-Up Studies</topic><topic>free flap</topic><topic>Humans</topic><topic>Laryngeal Neoplasms - radiotherapy</topic><topic>Laryngeal Neoplasms - surgery</topic><topic>Laryngectomy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>radiotherapy</topic><topic>recurrence</topic><topic>Retrospective Studies</topic><topic>salvage</topic><topic>Salvage Therapy</topic><topic>squamous cell carcinoma</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sandulache, Vlad C.</creatorcontrib><creatorcontrib>Vandelaar, Laura J.</creatorcontrib><creatorcontrib>Skinner, Heath D.</creatorcontrib><creatorcontrib>Cata, Juan</creatorcontrib><creatorcontrib>Hutcheson, katherine</creatorcontrib><creatorcontrib>Fuller, Clifton David</creatorcontrib><creatorcontrib>Phan, Jack</creatorcontrib><creatorcontrib>Siddiqui, Zuhair</creatorcontrib><creatorcontrib>Lai, Stephen Y.</creatorcontrib><creatorcontrib>Weber, Randal S.</creatorcontrib><creatorcontrib>Zafereo, Mark E.</creatorcontrib><collection>Istex</collection><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><jtitle>Head & neck</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sandulache, Vlad C.</au><au>Vandelaar, Laura J.</au><au>Skinner, Heath D.</au><au>Cata, Juan</au><au>Hutcheson, katherine</au><au>Fuller, Clifton David</au><au>Phan, Jack</au><au>Siddiqui, Zuhair</au><au>Lai, Stephen Y.</au><au>Weber, Randal S.</au><au>Zafereo, Mark E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Salvage total laryngectomy after external-beam radiotherapy: A 20-year experience</atitle><jtitle>Head & neck</jtitle><addtitle>Head Neck</addtitle><date>2016-04</date><risdate>2016</risdate><volume>38</volume><issue>S1</issue><spage>E1962</spage><epage>E1968</epage><pages>E1962-E1968</pages><issn>1043-3074</issn><eissn>1097-0347</eissn><abstract>Background
The purpose of this study was to present our evaluation of the clinical and functional outcomes after salvage total laryngectomy (STL).
Methods
We conducted a retrospective review of 218 patients who underwent STL between 1994 and 2014.
Results
Seventy percent of patients originally had T1 or T2, N0 tumors and 73% had definitive external‐beam radiotherapy (EBRT) alone. A majority utilized tracheoesophageal prosthesis (77%) and were gastrostomy free (80%) at last follow‐up. The 5‐year disease control and overall survival (OS) rates were 65% and 57%, respectively. Patients with a disease‐free interval after initial treatment <2 years were more likely to develop a recurrence (p = .001) and die of disease (p = .032) after STL. The disease‐free interval after EBRT impacted disease control (p < .001), with 5‐year disease control of 92% for >5‐year disease‐free interval and 60% for <2‐year disease‐free interval.
Conclusion
Most patients remain disease‐free after STL, achieve intelligible tracheoesophageal speech, and maintain an oral diet. Delayed recurrence after initial treatment portends better survival and may indicate a distinct biological profile. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1962–E1968, 2016</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>26879395</pmid><doi>10.1002/hed.24355</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Carcinoma, Squamous Cell - radiotherapy Carcinoma, Squamous Cell - surgery complications disease-free interval Disease-Free Survival Female fistula Follow-Up Studies free flap Humans Laryngeal Neoplasms - radiotherapy Laryngeal Neoplasms - surgery Laryngectomy Male Middle Aged Neoplasm Recurrence, Local radiotherapy recurrence Retrospective Studies salvage Salvage Therapy squamous cell carcinoma Survival Rate |
| title | Salvage total laryngectomy after external-beam radiotherapy: A 20-year experience |
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