Outcome of Salvage Total Laryngectomy Following Organ Preservation Therapy

Weber, Randal S.; Berkey, Brian; Forastiere, Arlene A.; Cooper, Jay S.; Maor, Moshe; Goepfert, Helmuth; Morrison, William H.; Glisson, Bonnie S.; Trotti, Andy; Ridge, John A.; Chao, K.S. Clifford; Peters, Glenn E.; Lee, D. J.; Leaf, Andrea; Ensley, John F.

doi:10.1001/archotol.129.1.44

Cited by 486 publications

(468 citation statements)

References 17 publications

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“…In other studies [18,[25][26][27][28] mean time of restoration a normal feeding was 25 days and in Pellini's study was in less than 1 month for 61.5 % of patients [22]. The time of removal of the feeding tube ranged in literature from 10-96 days [28] to 12-90 days [18], in our study was 4-230 days.…”

Section: Complications and Functional Resultssupporting

confidence: 38%

“…The incidence of late complications as stoma stenosis is estimated in literature about 9 % [5] while in our case study was 4 % and they all required surgical reintervention. The most common complication is pharyngocutaneous fistula, which had an incidence of 32 % in our study, 11.9 % in Ganly's and 30 % in Weber's [25]. The rate of pharyngocutaneous fistula following STL in irradiated patients is higher than that after total laryngectomy as primary treatment (from 68 to 8.69 % [30][31][32]).…”

Section: Complications and Functional Resultsmentioning

confidence: 62%

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Surgical options in radiotherapy-failed early glottic cancer

Santoro

Meccariello

Mannelli

et al. 2013

Eur Arch Otorhinolaryngol

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After failure of curative radiotherapy (RT), surgery is the main therapeutic option to control recurrent laryngeal cancer. Recurrences after RT for T1-T2 tumours of the glottic larynx are often diagnosed at a more severe stage than the original disease and, thus, usually treated by radical approaches. Our aim is to investigate the feasibility of more conservative strategies for proper treatment of post-RT recurred glottic cancer. We collected and reviewed our files from 1990 to 2006, selecting 75 patients which matched the following inclusion criteria: (1) patient was originally diagnosed with early stage squamous cell carcinoma of the glottic larynx (stage I-II according to 2010 TNM), (2) patient was treated by RT with curative intent, (3) patient presented a recurrence of disease after RT which was surgically treated at our Institution. T stage at first diagnosis was T1a in 41 cases (55 %), T1b in 12 (16 %) and T2 in 22 (29 %). At clinical examination of RT-recurred lesions, we documented advanced lesions (rT3-rT4) in 29 out of 75 patients (39 %). Overall, an upstage was reported for 56 % RT-recurred cancers, while 37.3 % remained at the same stage than the original tumour and 6.7 % were downstaged. Twelve patients (16 %) underwent salvage partial laryngectomy (SPL), while 63 (84 %) received a salvage total laryngectomy (STL). Multivariate analysis showed that rTNM according to the AJCC-UICC of 2010 was the only prognostic factor for both disease-free survival (p = 0.042) and overall survival (p = 0.004). Considering the prognostic impact of rT and rN we documented a statistical significance only in terms of overall survival for both factors (p = 0.004 and p = 0.04, respectively). Although STL remains the most frequent treatment choice for failures after RT in laryngeal carcinomas, SPL represents a valid option for selected patients with limited recurrence and can deliver good oncologic and functional results if performed according to careful indications.

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Section: Complications and Functional Resultssupporting

confidence: 38%

Section: Complications and Functional Resultsmentioning

confidence: 62%

Surgical options in radiotherapy-failed early glottic cancer

Santoro

Meccariello

Mannelli

et al. 2013

Eur Arch Otorhinolaryngol

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“…Higher survival rates for laryngeal cancer were confirmed after primary laryngectomy, and organ preservation strategy resulted in decrease of global survival for laryngeal cancer from 66% to 63% in the last years [1,4]. Radiotherapy for laryngeal cancer produces more frequent fistulas especially when bigger fields and doses were used.…”

Section: Discussionmentioning

confidence: 99%

“…Also, salvage surgery is accompanied by higher complication rate, and worse survival rate [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Survival after Salvage Total Laryngectomy: The Influence of Previous Treatment

Stanković¹,

Milisavljević²,

Stankovic³

2017

J Nucl Med Radiat Ther

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Purpose: To compare the complications and survival rate after different treatment modalities of advanced laryngopharyngeal cancer. Methods:Retrospective study included 619 advanced laryngopharyngeal carcinoma, treated with either primary total laryngectomy (PTL), or salvage (STL) after partial laryngectomy, radio, chemoradiotherapy. Complications and survival rate were documented.Results: Five years disease free survival rate amounted 60.9% for PTL, 54.3% for STL after partial laryngectomy, 50% for STL after radiotherapy and 43.8% for STL after chemoradiotherapy. Histologically positive neck was highly significantly associated with worse prognosis, much more than recurrence within larynx. Conclusion:PTL gives the best survival rate with low complications for advanced laryngopharyngeal squamous cell carcinoma. Complications and survival rate of STL significantly depend on previous treatment of laryngopharyngeal cancer.

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“…The risk of developing pharyngocutaneous fistulas is increased if radiation therapy has taken place previously [132], [133]. Data of the Radiation Therapy Oncology Group 91-11 and investigations from Japan reveal wound complication rates of 46-59%, with rates for pharyngocutaneous fistulas of 15-38% [134], [135]. Fung et al showed that reconstruction with microvascular free flaps in salvage surgery does avoid more extensive wound healing disorders [136].…”

Section: Specificities Of Wound Healing In Recurrences After Radio(chmentioning

confidence: 99%

Refinement of the free radial forearm flap reconstructive technique after resection of large oropharyngeal malignancies with excellent functional results

et al. 2003

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Preservation of function is a crucial aspect for the evaluation of therapies applied in the field of head and neck cancer. However, preservation of Uta Tschiesner 1 anatomic structures cannot automatically be equated with preservation 1 Clinic for Otorhinolaryngology, Ludwig Maximilians of function. Functional outcome becomes increasingly important particularly for the evaluation of alternative treatment options with equivalent oncological outcomes.University (LMU) Munich, Munich, GermanyAs a result, present studies take into account three topic areas with varying emphasis: (1) the effects of cancer therapy on essential physiological functions, (2) additional therapy-induced side-effects and complications, and (3) health-related quality of life. The present article summarizes vital aspects of clinical research from recent years. Functional outcomes after surgical and non-surgical treatment approaches are presented according to tumor localization and staging criteria. Additional methodological aspects relating to data gathering and documentation as well as challenges in implementing the results in clinical practice are also discussed.

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Outcome of Salvage Total Laryngectomy Following Organ Preservation Therapy

Cited by 486 publications

References 17 publications

Surgical options in radiotherapy-failed early glottic cancer

Surgical options in radiotherapy-failed early glottic cancer

Survival after Salvage Total Laryngectomy: The Influence of Previous Treatment

Refinement of the free radial forearm flap reconstructive technique after resection of large oropharyngeal malignancies with excellent functional results

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