High dose pre‐operative radiotherapy and surgery for cancer of the larynx.

Constable, William C.; Marks, Richard D.; Robbins, Jeffrey P.; Fitz‐Hugh, G. Slaughter

doi:10.1288/00005537-197210000-00008

Cited by 30 publications

(4 citation statements)

References 3 publications

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“…The distinction between the effects of preoperative and postoperative radiation on development of hypothyroidism has not been characterized in prior studies, and reports are contradictory as to whether preoperative radiation results in more morbidity than postoperative radiotherapy. [20][21][22][23][24][25] Concomitant surgery may interfere with the arterial blood supply and venous drainage to the remaining thyroid lobe, and as a result it may lack sufficient reserves to increase function and produce an adequate supply of thyroid hormone. The unique aspect of this study is that surgical variables remain fairly constant, allowing for a distinction to be made between the effects of preoperative and postoperative radiation treatment.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Hypothyroidism after Laryngectomy

Gal

Klotch

et al. 2000

Otolaryngol.--head neck surg.

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Hypothyroidism is a well-documented complication after treatment of head and neck cancer and is particularly significant among patients undergoing laryngectomy. The objective of this study was the identification of factors associated with the development of hypothyroidism in this population. Records of 136 patients treated with laryngectomy were retrospectively reviewed in an attempt to define a risk factor profile for patients in whom hypothyroidism is most likely to develop after laryngectomy. The Cox proportional hazards model was used to identify factors significantly related to an increased risk for development of hypothyroidism. The actuarial method was used to estimate the period of greatest risk for the development of hypothyroidism. Increased risks were found for patients who were female (P = 0.0049), received preoperative radiation therapy (P = 0.0022), had invasion of the thyroid gland by tumor (P = 0.0003), had presence of cervical metastases (P = 0.0022), and had postoperative fistula (P = 0.0095). From the actuarial method, we estimated that the period of time when patients were at greatest risk for development of hypothyroidism was between 0 and 14 months after surgical intervention. Wound complications were twice as frequent in hypothyroid patients. Perioperative awareness of risk factors associated with the development of hypothyroidism in patients undergoing laryngectomy allows for early recognition and management of hypothyroidism and may reduce the number of complications related to wound healing and fistula.

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Section: Discussionmentioning

confidence: 99%

Risk Factors Associated with Hypothyroidism after Laryngectomy

Gal

Klotch

et al. 2000

Otolaryngol.--head neck surg.

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“…Four of the patients with fistulas received more than the usual dose of 3,000 rads preoperatively. Five cases were subsequently treated for local persistence (I) or distant metastases (4 ) . Two patients had diabetes mellitus and a third developed hepatic failure postoperatively.…”

Section: Methodsmentioning

confidence: 99%

Incidence, Predisposing Factors and Outcome of Pharyngocutaneous Fistulas Complicating Head and Neck Cancer Surgery

Dedo¹,

Alonso²,

Ogura³

1975

Ann Otol Rhinol Laryngol

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A major complication of head and neck cancer surgery following radiation and extensive resection is pharyngocutaneous fistula. A retrospective analysis of 36 fistula patients out of 376 major head and neck procedures between January 1971 and July 1973 revealed certain guidelines for improved clinical management. Since a large discrepancy existed in the incidence of fistulas between the different surgical procedures, each operative group was examined separately. The incidence, predisposing factors, and methods of treatment for this complication following composite jaw-neck resections and various laryngeal procedures are analyzed and discussed.

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“…Many authors have reported seemingly improved local control, though not always with increased survival, when preoperative radiation was used [Constable et al, 1972;Donald, 1977;Goldman et at, 1972;Hendrickson et al, 1968: Levitt andKing, 1971 ;Krause and McCabe, 1973;Powers and Ogura, 1969;Roswit et at, 1972;Salmo et al, 1977;Sanfillipo et al, 1969;Wanget al, 19721. Equivalent dosages of 3000 rads/3 weeks or less (note that 2000 rads/l week is nearly equivalent to 3000 rads/3 weeks) may have less efficacy than higher dosages [Lawrence et al, 1974;Ogura and Biller, 1970;Powers and Ogura, 19691.…”

Section: Discussionmentioning

confidence: 99%

Randomized study of control of the primary tumor and survival using preoperative radiation, radiation alone, or surgery alone in head and neck carcinomas

Hintz

Charyulu

Chandler

et al. 1979

Journal of Surgical Oncology

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Fifty-five selected patients with previously untreated squamous cell carcinoma of the head and neck regions were studied in a randomized, prospective manner. The three treatment categories were primary radiation (Gp R), primary surgery (Gp S), and preoperative radiation of 4000 rads in four weeks (Gp R/S). The local control rates for the 44 evaluable patients with a two-year minimum followup were 24%, 39%, and 43% respectively. Further treatment attempts in patients failing initial therapy yielded local control rates of 35%, 39%, and 43% for Gp R, Gp S, and Gp R/S, respectively. None of the local control rates nor the corresponding survival curves were significantly different at P less than 0.10. However, the group sizes were sufficiently small that true differences might not have been detected. Postoperative complications were higher in the primary radiation failures subsequently operated upon compared to the primary surgery group (P = 0.07).

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High dose pre‐operative radiotherapy and surgery for cancer of the larynx.

Cited by 30 publications

References 3 publications

Risk Factors Associated with Hypothyroidism after Laryngectomy

Risk Factors Associated with Hypothyroidism after Laryngectomy

Incidence, Predisposing Factors and Outcome of Pharyngocutaneous Fistulas Complicating Head and Neck Cancer Surgery

Randomized study of control of the primary tumor and survival using preoperative radiation, radiation alone, or surgery alone in head and neck carcinomas

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