Oncologic Outcomes After Salvage Laryngectomy for Squamous Cell Carcinoma of the Larynx and Hypopharynx: A Multicenter Retrospective Cohort Study

Meulemans, Jeroen; Debacker, Jens; Demarsin, Hannelore; Vanclooster, Christophe; Neyt, Peter; Mennes, Tillo; Vauterin, Tom; Huvenne, Wouter; Laenen, Annouschka; Delaere, Pierre; Poorten, Vincent Vander

doi:10.1245/s10434-020-09017-0

Cited by 13 publications

(22 citation statements)

References 21 publications

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“…We have achieved negative margins in 80.6 per cent of our cohort, which is equal to or better than other large studies. 3,4,17,18 Positive or close margins after resection are considered negative prognostic factors, 4,18 although there is no universal agreement. 6 Indeed 4 out of 6 patients with positive or close margins have died from their cancer in our cohort (66.7 per cent).…”

Section: Discussionmentioning

confidence: 99%

“…26 The rate of post-salvage total laryngectomy fistula in our study was 29 per cent, which is in agreement with the literature. Chemoradiotherapy at primary treatment, 12 bilateral neck dissection, 5 prior tracheostomy 27 and pre-operative haemoglobin levels 17 predispose the patient to fistula formation. Two meta-analyses and one recent study, led by the Microvascular Committee of the American Academy of Otolaryngology Head and Neck Surgery, support the prophylactic use of vascularised tissue (free flaps and regional flaps) in reducing the rate of fistula.…”

Section: Discussionmentioning

confidence: 99%

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Twenty-year experience with salvage total laryngectomy: lessons learned

et al. 2021

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Objective The purpose of this study was to evaluate the outcome of salvage total laryngectomy and identify areas for further improvement. Method A retrospective analysis of all patients who underwent salvage total laryngectomy between January 1999 and December 2018 was performed. Results Thirty-one patients were identified. The most common primary tumour site was the glottis (83.8 per cent). Early stage (T1–T2) disease was identified in 83.9 per cent of cases. Overall survival at 2 and 5 years post-salvage total laryngectomy was 71 per cent and 45 per cent, respectively. Disease-free survival at 2 and 5 years post-salvage total laryngectomy was 65 per cent and 42 per cent, respectively. The rate of post-salvage total laryngectomy pharyngocutaneous fistula was 29 per cent. Conclusion More than half of patients will not survive beyond five years after salvage total laryngectomy. Regional recurrence was the most common form of failure and death. From this study, elective lateral and central neck dissection is advocated in patients with early laryngeal cancer who present with an advanced recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Twenty-year experience with salvage total laryngectomy: lessons learned

et al. 2021

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“…Laryngeal and hypopharyngeal cancers have frequently been investigated as a single entity and shared similar treatment strategies 4 , 7 , 8 , 10 , 11 , 14 . To the best of our knowledge, this is the first study to investigate the prognostic value of pretreatment AAPR in locally advanced laryngeal and hypopharyngeal cancer (LA-LHC).…”

Section: Discussionmentioning

confidence: 99%

“…More than 50% of LHC patients are diagnosed with the locally advanced disease during their initial clinical consultation [6]. The 5-year overall survival (OS) and disease-free survival (DFS) of locally advanced laryngeal and hypopharyngeal cancer (LA-LHC) were in the range of 47.7-60.2% and 42.2-69.4%, respectively, according to various publications [7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of pretreatment albumin-to-alkaline phosphatase ratio in locally advanced laryngeal and hypopharyngeal cancer: Retrospective cohort study

You

Jiang

et al. 2021

J. Cancer

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Background: This study was designed to assess the prognostic significance of pretreatment albumin-toalkaline phosphatase ratio (AAPR) in locally advanced laryngeal and hypopharyngeal cancer (LA-LHC). Materials and Methods:The clinical data of 341 patients with locally advanced laryngeal and hypopharyngeal cancer diagnosed between March 2007 and December 2018 were retrospectively collected and analyzed. The optimal cut-off value of AAPR for evaluating DFS was determined using the ROC curve, and 0.4912 was selected. Based on pretreatment AAPR values, patients were divided into two groups (low vs. high AAPR). Survival analysis was used to investigate the survival distribution between the groups. Univariate and multivariate analyses were performed to evaluate the prognostic value of AAPR. Based on the results of the multivariate analysis, we further developed models of DFS and OS. We assigned low AAPR, N1-3, age ≥65 years, and positive vascular invasion one score, respectively. Results: Survival analysis demonstrated that the survival of patients with low and high AAPR was significantly different (low vs. high AAPR: 5-year DFS, 46.0 vs. 71.9%, p<0.001; 5-year OS, 69.0 vs. 72.6%, p<0.001). Univariate and multivariate analyses further showed that pretreatment AAPR served as an independent indicator in LA-LHC. Moreover, survival analysis showed that patients with high model score had poorer DFS and OS (5-year DFS: 58.1, 42.7, 26.9 and 9.1% of score zero, one, two, and three respectively, p<0.001; 5-year OS: 63.0, 50.3, 34.1 and 28.6% of score zero, one, two, and three respectively, p<0.001). Conclusion: Pretreatment AAPR could be an independent prognostic indicator in patients with LA-LHC. Incorporating AAPR into the risk stratification model might better categorize patients with worse oncological outcomes and support treatment strategy making.

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“…Studies have demonstrated that survival rates for chemoradiation are equivalent to surgery, allowing for laryngeal preservation in approximately two thirds of patients 4,5 . The remainder experience persistent disease necessitating a salvage laryngectomy, which is often associated with higher rates of long‐term complications and poorer survival outcomes 6,7 …”

Section: Introductionmentioning

confidence: 99%

Randomized trial of laryngeal organ preservation evaluating two cycles of induction chemotherapy with platinum, docetaxel, and a novel Bcl‐xL inhibitor

et al. 2022

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Background Single cycle induction chemotherapy (IC) with platinum and 5‐flurouracil (PF) and treatment based on clinical response predicts organ preservation in laryngeal cancer. Other agents offer intriguing alternatives with potentially increased ease of administration, reduced risk for severe toxicities, and increased platinum sensitivity. Methods We report the results of a phase II bioselection trial in advanced resectable laryngeal cancer utilizing an IC regimen of two cycles of platinum plus docetaxel (TP) with a Bcl‐2 inhibitor. The primary endpoint was organ preservation rate at 12 weeks post chemoradiation. Results Fifty‐four patients were enrolled. Response to IC was 72%. The organ preservation rate was 59% with a laryngectomy free survival of 46%. Induction related grade ≥3 toxicities were observed in 56% of patients with two grade 5 events. Conclusions Two cycles of TP IC plus a Bcl‐2 inhibitor did not improve laryngeal preservation compared to a single cycle of PF.

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Oncologic Outcomes After Salvage Laryngectomy for Squamous Cell Carcinoma of the Larynx and Hypopharynx: A Multicenter Retrospective Cohort Study

Cited by 13 publications

References 21 publications

Twenty-year experience with salvage total laryngectomy: lessons learned

Twenty-year experience with salvage total laryngectomy: lessons learned

Prognostic role of pretreatment albumin-to-alkaline phosphatase ratio in locally advanced laryngeal and hypopharyngeal cancer: Retrospective cohort study

Randomized trial of laryngeal organ preservation evaluating two cycles of induction chemotherapy with platinum, docetaxel, and a novel Bcl‐xL inhibitor

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