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- Title
Partial Laryngeal Surgery for Intermediate Larynx Cancer.
- Authors
Beswick, Daniel M.; Caicedo‐Granados, Emiro E.; Cunningham, Diana E.; Christopoulos, Apostolos; Kubicek, Gregory J.; Heron, Dwight E.; Ferris, Robert L.
- Abstract
Objective: Chemoradiation trials over the past 2 decades have assumed that the primary surgical option for intermediate stage laryngeal cancer (T2‐T3/N0‐N1) was total laryngectomy. However, partial laryngeal surgery (PLS), including transoral laser microsurgery (TLM) and supracricoid partial laryngectomy (SCL), can provide sound oncologic and functional outcomes, often without adjuvant therapy. Method: We retrospectively evaluated oncologic and functional outcomes in laryngeal squamous cell carcinoma (LSCC) patients who underwent TLM or SCL from 1998‐2010. Overall survival (OS) and recurrence‐free survival (RFS) were calculated. The Communication Scale (CS) and Functional Outcome Swallowing Scale (FOSS) were used to evaluate speech and swallowing, respectively. Results: Eighty‐one patients were analyzed with median follow‐up of 31 months. Eighty‐four percent were T2‐T3/N0‐N1. Two‐ and 5‐year OS probabilities were 84.2% (95% CI: 73.0‐91.0%) and 59.3% (95% CI: 41.4‐73.3%), respectively. There was no difference between the TLM and SCL cohorts in OS (P =. 781) or RFS (P =. 456). Ninety‐four percent of patients still had a larynx at median 31 months. Seventy‐five percent of patients avoided adjuvant therapy, including 67% of TLM and 84% of SCL patients. CS and FOSS were 2‐or‐better in 95% and 88%, respectively, designating functional postoperative voice and swallowing. TLM patients were more likely to have a CS of 2‐or‐better postoperatively (P =. 041). Conclusion: PLS can provide good oncologic and functional outcomes for intermediate stage LSCC and is an alternative to chemoradiation or total laryngectomy in select patients.
- Publication
Otolaryngology-Head & Neck Surgery, 2012, Vol 145, Issue 2, pP63
- ISSN
0194-5998
- Publication type
Article
- DOI
10.1177/0194599812451438a85