Clinical and functional outcomes after total laryngectomy and laryngopharyngectomy: Analysis by tumor subsite, salvage status, and extent of resection

Perdoni, Christopher; Santarelli, Griffin D.; Koo, Elliot Y.; Karakla, Daniel W.; Bak, Matthew J.

doi:10.1002/hed.25807

Cited by 8 publications

(7 citation statements)

References 25 publications

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“…In line with this, a recent study reported that only 42.9% (n = 7) and 5.3% (n = 19) achieved a normal diet after PPL and TPL, respectively. 23 Therefore, our data support a significant number of patients requiring a modified diet after pharyngeal resection and the need for clear communication of this complication.…”

Section: Discussionsupporting

confidence: 65%

Functional Outcomes Following Total Laryngectomy and Pharyngolaryngectomy: A 20-Year Single Center Study

Layton

Thomas

Harris

et al. 2022

Ann Otol Rhinol Laryngol

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Background: Laryngeal cancer accounts for 1% of all cancers in men and 0.3% of all cancers in women. Pharyngolaryngectomy (TPL) and total laryngectomy (TL) are central surgical techniques in the management of advanced laryngeal malignancies but are associated with significant morbidity. In addition, optimal reconstruction following TPL remains an area of active research. Methods: Here, we compared speech and swallowing outcomes following circumferential and partial pharyngeal resection alongside total laryngectomy in patients with laryngeal and hypolaryngeal tumors. We performed a systemic analysis of patient demographics, tumor characteristics, treatment modality, and pharyngeal reconstruction technique following TPL and TL, leveraging data collected over a 20-year period at a large tertiary referral center. Results: Analyzing 155 patients the results show circumferential pharyngeal defects and prior radiotherapy have a significant impact on surgical complications. Conclusion: Pharyngeal resection carries a substantial risk of incurring impaired speech and swallowing in patients. Moreover, our results support poorer functional outcomes with more radical pharyngeal resections and show a clear trend toward worse swallowing outcomes in salvage surgery.

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Section: Discussionsupporting

confidence: 65%

Functional Outcomes Following Total Laryngectomy and Pharyngolaryngectomy: A 20-Year Single Center Study

Layton

Thomas

Harris

et al. 2022

Ann Otol Rhinol Laryngol

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“…L'hématome et l'infection post-opératoire sont rares [14]. L'ablation du larynx s'accompagne de troubles fonctionnels importants pouvant altérer considérablement la qualité de vie du patient [15,16]. La perte définitive de la voix peut être corrigée par divers moyens et techniques [7,8,16,17].…”

Section: Discussionunclassified

“…Le taux de métastases à distance n'est pas négligeable : 7% [5]. Le taux de survie à 5 ans varie entre 40 et 60% dans les cancers du larynx [4,9,14,15]. Dans notre étude, ce taux de 33% pourrait être amélioré avec la disponibilité des traitements adjuvats et le suivi régulier des patients.…”

Section: Discussionunclassified

Résultats carcinologiques et fonctionnels des laryngectomies pour cancer du larynx à l’Hôpital Principal de Dakar

Ca¹,

Loum²,

Diallo³

et al. 2021

Af J Oncol

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INTRODUCTION: Delay in the diagnosis of cancers of the larynx affects the prognosis and often requires very mutilating surgery. AIM: To report the oncologic and functional outcomes of surgery for laryngeal cancers to Hôpital Principal de Dakar in Senegal. MATERIALS AND METHODS: This was a single-center retrospective study carried out from January 2009 to December 2014 in the ENT and head and neck surgery department including adult patients treated for curative surgery. RESULTS: Fifty patients were treated for laryngeal cancer. Thirty-seven of them underwent a laryngectomy. Lesions classified as cT2 represented 14%, and 16% were classified as cT1. Squamous cell carcinomas represented more than 97% of cases (36/37). Radiotherapy had completed the surgery in only 11 cases with an average delay of 2.75 months. Functionally, swallowing disorders were found in two patients with two cases of pharyngo-esophageal stenosis. On the carcinologic level, six patients presented a progression while four had tumor or lymph node recurrence. One patient showed lung metastasis. Overall survival at 7 years was 33%. CONCLUSION: The functional damage in laryngeal cancer surgery is significant and on the carcinologic level the results, although satisfactory, can be improved with a better availability of adjuvant treatments.

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“…In addition, the vast majority of studies have included nonoral cavity sites within the analysis, 1,5,7,10 thereby introducing bias. Clean contaminated surgery of the oral cavity differs from that of other sites such as oropharynx and laryngopharynx in several important aspects such as the distribution of commensal and pathogenic bacteria, wound exposure to gastric acid reflux, 6,11 postoperative ability to swallow and cough, 12 need for and duration of tracheostomy, and need for mandibular resection. Furthermore, there is a paucity of studies examining risk factors for pneumonia.…”

Section: Introductionmentioning

confidence: 99%

Predictors of surgical site infection and pneumonia following oral cavity tumor surgery

Karthik

Dhiwakar

2021

Head & Neck

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Background To identify risk factors for surgical site infection (SSI) and pneumonia following oral cavity tumor surgery. Methods Retrospective chart review of a consecutive series of patients undergoing oral cavity resection. Several clinicopathologic variables were tested for their association with SSI and pneumonia. Results Three hundred and forty‐four cases in 330 patients were included. Incidence of SSI and pneumonia was 67 (19.5%) and 38 (11%), respectively. On multivariate analysis, marginal mandibulectomy and segmental mandibulectomy were independent risk factors for SSI, whereas time under anesthesia (TUA) was an independent risk factor for pneumonia. Receiver operating characteristic curve identified 390 min as the cutoff above which pneumonia was predicted with a high degree of accuracy. Conclusions In oral cavity resections, mandibulectomy predisposes to SSI. Further, prolonged TUA (>390 min) is a powerful predictor for pneumonia. As it is a modifiable risk factor, reduction in TUA might correspondingly lower the incidence of postoperative pneumonia.

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Clinical and functional outcomes after total laryngectomy and laryngopharyngectomy: Analysis by tumor subsite, salvage status, and extent of resection

Cited by 8 publications

References 25 publications

Functional Outcomes Following Total Laryngectomy and Pharyngolaryngectomy: A 20-Year Single Center Study

Functional Outcomes Following Total Laryngectomy and Pharyngolaryngectomy: A 20-Year Single Center Study

Résultats carcinologiques et fonctionnels des laryngectomies pour cancer du larynx à l’Hôpital Principal de Dakar

Predictors of surgical site infection and pneumonia following oral cavity tumor surgery

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