Management of Cancer of the Supraglottis

Scola, Bartolomé; Fernández-Vega, M; Martínez, Teresa; FernÁNdez-Vega, Susana; Ramı́rez, Carlos A.

doi:10.1067/mhn.2001.112202

Cited by 54 publications

(47 citation statements)

References 15 publications

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“…Scola et al 11 achieved an overall actuarial survival rate of 80.6% at 5 years in a sample of 590 patients with disease from stage II who received classic supraglottic laryngectomy. Similar data from smaller series were reported by Maurizi et al, 12 with an overall survival rate of 83% at 5 years in a sample of 94 patients with supraglottic tumor stages I and II, and by Herranz Gonzales et al, 13 with an adjusted survival rate of between 77% and 74% at 5 years for T1 -T2 supraglottic tumors (67 cases).…”

Section: Methodsmentioning

confidence: 99%

CO₂ laser treatment of supraglottic cancer

Motta

Esposito

Testa³

et al. 2004

Head & Neck

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Background. The aim of the study was to evaluate the effectiveness of endoscopic CO 2 laser microsurgery in the management of supraglottic cancer.Methods. One hundred twenty-four patients (116 men and eight women; mean age, 59 years; range, 31 -81 years) with supraglottic cancer underwent CO 2 laser surgery (mean followup 5 years). The study patients were classified as follows: 45 patients, T1N0M0; 61 patients, T2N0M0; and 18 patients, T3N0M0. According to the staging, the following procedures were adopted: epiglottectomy, resection of aryepiglottic fold or false vocal cord in T1 patients (group A); resection of the false vocal cord and adjacent structures in T2 patients (group B); and supraglottic laryngectomy in T3 patients (group C). Statistical comparison of survival parameters was carried out with Wilcoxon test, considering p < .05 the minimum significance value.Results. Overall actuarial survival, adjusted actuarial survival, and no evidence of disease at 5 years were 91%, 97%, and 82% in group A; 88%, 94%, and 59% in group B; and 81%, 81%, and 51% in group C, respectively. The statistical analysis of survival parameters showed a significant difference in the comparison of T1 versus T2 and T2 versus T3 tumors (p < .01). Actuarial local control, actuarial nodal control, and actuarial distant metastasis control at 5 years were 82%, 82%, and 100% in T1 patients; 63%, 90%, and 98% in T2 patients; and 77%, 75%, and 93% in T3 patients. Laryngeal preservation rate was 88.6% in T1 patients, 85.4% in T2 patients, and 93.7% in T3 patients. Patients in groups A and B were discharged after 3 to 12 days, and patients in group C were discharged after 14 to 20 days.Conclusions. The results of this study show that endoscopic CO 2 laser surgery is highly effective in the treatment of T1 and T2 supraglottic cancer. In T3 cancer, the CO 2 laser should be implemented in those cases in which radical excision by endoscopic route is feasible. In 1978, Vaughan 1 first described the use of CO 2 laser in the treatment of early supraglottic cancer. In 1984, Motta et al illustrated the endoscopic surgical technique of supraglottic laryngectomy 2 and subsequently indicated the guidelines for supraglottic cancer resection with CO 2 laser, 3 which were validated and confirmed by other authors. 4 -7 The aim of this study was to evaluate the effectiveness of CO 2 laser microsurgery in the management of supraglottic cancer.

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Section: Methodsmentioning

confidence: 99%

CO₂ laser treatment of supraglottic cancer

Motta

Esposito

Testa³

et al. 2004

Head & Neck

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“…As treatment option for supraglottic cancer Scola et al [16] published the management of supraglottic tumor representing a series of 903 patients, but only 12 patients underwent transoral resection; the majority received a classical supraglottic laryngectomy with bilateral neck dissection and postoperative radiation therapy. Postoperative results of swallowing, quality of voice and respiration were found to be good over 80% of their patients.…”

Section: Discussionmentioning

confidence: 99%

“…In some supraglottic laryngectomy patient's material reported, the endoscopic supraglottic laser surgery was used more rarely [16,17].…”

Section: Discussionmentioning

confidence: 99%

Transoral CO2 laser management for selected supraglottic tumors and neck dissection

Csanády

Czigner

Vass

et al. 2011

Eur Arch Otorhinolaryngol

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This study aimed to evaluate transoral laser resection as a method of choice for conservation surgery for supraglottic laryngeal carcinoma in carefully selected patients. Between 1987 and 2006, 55 patients with early supraglottic carcinoma were selected for transoral laser surgery. The outcome of the endoscopic CO(2) laser resection and larynx-sparing functional results without tracheotomy was evaluated. Fifty-five patients with T1, T2 supraglottic carcinomas underwent transoral CO(2) laser resection and seven patients with manifest neck metastasis required a neck dissection at one session with additional postoperative radiation therapy. There was no need for tracheotomy; deglutition was moderately disturbed. Forty of the 55 (73%) patients had no signs of recurrence to date. Fifteen patients with local recurrences underwent salvage therapies: six repeated laser excisions, three radiotherapies, four supraglottic laryngectomies and two total laryngectomies. Laser-specific survival is 84% and larynx preservation is 96%. The overall 5-year-survival after salvage treatment is 98%. Development of late metastasis required five radical neck dissections (RND) and radiation therapy. The results indicated that transoral laser resection can control early supraglottic cancer in selected patients and can be combined with simultaneous neck dissection with less morbidity than "open surgery".

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“…17,19,33 Bir kısım yazar ise N0 boyunlarda, bilateral elektif boyun diseksiyonu önermektedirler. [34][35][36] Çünkü görünüşte negatif olan diseksiyonların bile %5-8'inde rutin patolojik incelemelerle mikrometastaz tespit edilmiştir. 37,38 Ayrıca ışık mikroskobu ile gösterilemeyen mikrometastatik hastalığın immunohistokimyasal ve moleküler çalış-malar ile %5 oranında gösterilebildiği unutulmamalıdır.…”

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The relationship between the frequency of cervical metastases and tumor related factors in laryngeal cancer and outcome of surgical treatment in these cases

Şengül

Bağlam²,

Çevik³

et al. 2012

J Clin Exp Invest

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Objectives: We aimed to assess the associations between localization, size, stage and histopathological differentiation of primary tumor in larynx and neck metastases and the impact of disease stage on survival. Materials and methods:We analyzed the medical records of 333 laryngeal cancer patients who underwent total or partial laryngectomy as primary treatment, combined with neck dissection and/or postoperative radiotheraphy if required, between 2000 and 2010 years at our clinic. Age and gender of patients, tumor localization, size, stage and histopathological differentiation of tumor; presence of preoperative positive lymph nodes, performed operations, operation findings and histopathological results were analysed retrospectively. Results:Tumor localizations were glottic in 172 (51.6%) cases, supraglottic in 108 (32.4%), and transglottic 53 (15.9%) of the the cases. In glottic cancers; cervical metastases were observed in 18.6% of the patients, whereas occult metastases in 11%. In supraglottic cancers; cervical metastasis rate was 45.3% and occult metastases rate was 24%. In transglottic cancers, cervical metastases rate was 49% and occult metastases was 22.6%. Postoperative recurrence was 41 (12.3%). Postoperative radiotherapy was recommended to 111 of 333 patients. The overall survival rate was 75.4% at 50th month and the cumulative survival rate was 68.9%. Conclusion:In conclusion, although there is controversy regarding the optimal treatment in the N0 larynx cancers, in case of a high risk for occult metastases, elective unilateral or bilateral neck dissection should be performed according to the anatomic localization of the tumor. In addition, survival rate decreased significantly with the increasing tumor stage. J Clin Exp Invest 2012; 3(2): 214-222Key words: Larynx cancer, localization, stage, cervical lymph node metastases, survival ÖZET Amaç: Çalışmamızda larenkste tespit edilen primer tümörün lokalizasyonu, büyüklüğü, evresi, histopatolojik diferansiasyon derecesi, tutmuş olduğu anatomik yapı ile boyun metastazı arasındaki ilişkisi ve tümörün evresinin sağkalım üzerine olan etkisini araştırdık. Gereç ve yöntem:Kliniğimizde 2000-2010 yılları arasında larenks kanseri nedeniyle primer tedavi olarak cerrahi (total veya parsiyel larenjektomi) uygulanmış olan, gerektiğinde boyun diseksiyonu yapılan ve gerektiğinde postoperatif radyoterapi uygulanan 333 hastanın dosyaları incelendi. Hastaların yaşı, cinsiyeti, tümörün lokalizasyonu, tümörün büyük-lüğü, tümörün evresi, histopatolojik diferansiasyon derecesi, preoperatif pozitif lenf nodu bulunup bulunmadığı, yapılan ameliyatlar, ameliyat bulguları ve postop spesmenin histopatolojik değerlendirme sonuçları retrospektif olarak incelendi. Bulgular: Tümörün yerleşim bölgesine göre; vakaların 172'si (%51.6) glottik, 108'i (%32.4) supraglottik, 53'ü (%15.9) ise transglottik yerleşimliydi. Glottik tümörlerde %18.6 oranında servikal metastaz, %11 oranında occult metastaz tespit edilirken, supraglottik tümörlerde %45.3 oranında servikal metastaz, %24 oranında...

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Management of Cancer of the Supraglottis

Cited by 54 publications

References 15 publications

CO₂ laser treatment of supraglottic cancer

CO₂ laser treatment of supraglottic cancer

Transoral CO2 laser management for selected supraglottic tumors and neck dissection

The relationship between the frequency of cervical metastases and tumor related factors in laryngeal cancer and outcome of surgical treatment in these cases

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Management of Cancer of the Supraglottis

Cited by 54 publications

References 15 publications

CO2 laser treatment of supraglottic cancer

CO2 laser treatment of supraglottic cancer

Transoral CO2 laser management for selected supraglottic tumors and neck dissection

The relationship between the frequency of cervical metastases and tumor related factors in laryngeal cancer and outcome of surgical treatment in these cases

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Product

Resources

About

CO₂ laser treatment of supraglottic cancer

CO₂ laser treatment of supraglottic cancer