Predictors and outcomes for chronic tracheostomy after chemoradiation for advanced laryngohypopharyngeal cancer

Jefferson, Gina D.; Wenig, Barry L.; Spiotto, Michael T.

doi:10.1002/lary.25585

Cited by 19 publications

(22 citation statements)

References 21 publications

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“…Moreover, it has been proposed that tracheostomy is an adverse prognostic factor for the oncological outcome of patients with laryngeal cancer . However, this observation was not confirmed in cases of locoregionally advanced laryngeal cancers . Our study identifies locoregional relapse as an adverse factor for chronic tracheostomy dependency in patients undergoing tracheostomy for the initial treatment.…”

Section: Discussioncontrasting

confidence: 55%

“…The only surrogate factor regarding the primary tumor characteristics was a higher decannulation rate for supraglottic tumors. Similarly, a recent study by Jefferson et al (2015) identified subglottic extension as a risk factor for chronic tracheostomy dependency. However, they analyzed laryngeal and hypopharyngeal tumors together in a cohort of patients exclusively treated by CRT.…”

Section: Discussionmentioning

confidence: 84%

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Risk analysis for tracheostomy dependency in curatively treated laryngeal cancer with organ preservation

et al. 2018

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Background A tracheostomy has an enormous negative impact on the patient's quality of life. The purpose of this study is to describe risk factors for permanent tracheostomies in patients undergoing curative organ‐preserving treatment of laryngeal cancer. Methods The charts of all patients with laryngeal cancer diagnosed at our tertiary referral center were reviewed. Cases receiving a tracheostomy before, during, or after primary organ‐preserving treatment were eligible. Results A total of 87 patients who underwent tracheostomies were enrolled in the present study. During follow‐up, 48 patients (55%) required a permanent tracheostomy, whereas 39 patients (45%) were decannulated. Multivariate analysis revealed primary radiotherapy (RT; odds ratio [OR] 12.857; P < .001) and recurrence (OR 25.84; P < .001) as independent factors of permanent tracheostomy. Conclusion This study identifies primary curative RT and tumor relapse as independent risk factors of permanent tracheostomy dependency in patients with laryngeal cancer undergoing a tracheostomy during or after primary curative organ‐preserving treatment.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 84%

Risk analysis for tracheostomy dependency in curatively treated laryngeal cancer with organ preservation

et al. 2018

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“…Tracheostomy rates in this review ranged from 0% to 6%. Small studies looking at tracheostomy in patients treated with chemoradiation ranged between 36% and 57% …”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta‐analysis of transoral laser microsurgery in hypopharyngeal carcinoma

Lane

Rabbani

Linton

et al. 2020

Laryngoscope Investig Oto

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Background Transoral laser microsurgery has been suggested as an alternative treatment modality for hypopharyngeal carcinoma. The purpose of this study is to systematically review the oncologic and functional outcomes of patients with hypopharyngeal carcinoma when treated with primary transoral laser microsurgery. Methods A comprehensive literature search was performed using PRISMA methodology on OVID MEDLINE and EMBASE. Meta‐analysis was completed for oncological outcomes. Results Six studies reported quality of life outcomes five reported oncologic outcomes. A median of 95% (range 0.83‐0.98) patients achieving gastrostomy independence, a median of 3% (range 0%‐6%) were tracheostomy dependent, and a median of 97% (Range 0.89‐1.0) were able to preserve their larynx. Pooled five‐year overall survival was 54% (CI, 0.50‐0.58, I2 = 29%), pooled disease‐specific survival was 72% (CI, 0.68‐0.77, I2 = 46%), and pooled local control rate was 78% (CI, 0.72‐0.85, I2 = 69%). Conclusion Systematic review supports improvements in functional outcomes and oncologic outcomes with transoral laser microsurgery.

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“…Trakeostominin avantajlı yönleri arasında, trakeanın temizlenmesinin kolaylaşması ve trakeal yolla ilaç tatbiki mümkün olması da sayılabilmektedir. 10,47,48 Trakeostomili hastada aspirasyon yaşamsal öneme sahiptir. Uzamış trakeostomide ise hem motor nöronlar ve bunların nükleusundaki davranış değişiklikleri hem de kasların tonuslerini kaybetmelerinden dolayı dekanülasyon döneminde aspirasyon ve solunum sıkıntısı gibi durumlar ortaya çıkabil-mektedir.…”

Section: Trakeostomi̇ Bakimiunclassified

“…Bununla birlikte, aspirasyonda asepsinin önemi ve kanül çevresinin temizliği hakkında bilgilendirilmesi gerekmektedir. 10,47,48 AĞIZ KURULUĞU YÖNETİMİ Baş-boyun kanserlerinde radyoterapi sıklıkla tedavi hacmindeki tükürük bezlerini içermekte; tükürük bezlerine verilen hasar, tükürük akışını önemli derecede azaltmaktadır. Bu duruma ağız kuruluğu ve mukozitler de sıklıkla eşlik edebilmektedir.…”

Section: Trakeostomi̇ Bakimiunclassified

Rehabilitation Nursing in Head Neck Cancer Patients

Kirca¹,

Kutlutürkan²

2018

Turkiye Klinikleri J Nurs Sci

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aş-boyun kanserleri, sindirim sistemi ve üst solunum yolu mukozalarından kaynaklanan skuamöz hücreli kanserlerdir. Skuamöz hücreli karsinom tüm baş-boyun kanserlerinin %90'ını oluşturmaktadır ve Baş-Boyun Kanserli Hastalarda Rehabilitasyon Hemşireliği Ö ÖZ ZE ET T Baş-boyun kanserlerinin %90'ını oluşturan skuamöz hücreli kanserler daha çok genetik yatkınlığı olan, alkol ve/veya sigara tüketen, 40 yaş üzerindeki erkeklerde görülmektedir. Baş-boyun kanseri tanısı konan bireyler, hastalık ve tedavi ile ilişkili olarak birçok semptomu ayrı ayrı veya bir arada deneyimlemektedir. Bu semptomların başlıcaları; yorgunluk, ağrı, kilo kaybı, iştahsızlık, disfaji, ağız kuruluğu, tükürük salgısında azalma, tat almada değişim ve diş problemleridir. Baş-boyun kanserli hastaların rehabilitasyon programının başlıca konuları; konuşma terapisi, beslenme ve stoma bakımı, çiğneme ve yutma terapisi ile ağrı yönetimidir. Hastaların fonksiyonel ve kozmetik sorunlarla baş edebilmesi için sağlık profesyonellerinin interdisipliner ekip yaklaşımıyla hastayı değerlendirmesi gerekmektedir. Ekip üyelerinden rehabilitasyon hemşiresinin hem bir vaka yöne-ticisi hem de hasta ve ailesinin tedaviye dâhil edilmesi, eğitim (trakeostomi bakımı, evde egzersizlerin yapılması) verilmesi, özbakımı ve öz yeterliliği geliştirme, komplikasyonların önlenmesi ve optimum fonksiyonu sağlama gibi görevleri bulunmaktadır. Baş-boyun kanserli hastalarda rehabilitasyon hemşirelerinin etkin bir şekilde bakıma katılmalarıyla hastaların yaşadıkları semptomların ve yaşam kalitelerinin artacağı düşünülmektedir.A An na ah ht ta ar r K Ke el li im me el le er r: : Baş ve boyun neoplazileri; rehabilitasyon; hemşirelik A AB BS ST TR RA AC CT T Squamous cell cancer, accounting for 90% of head and neck cancers, often occurs in males aged above 40 years with genetic predisposition, alcohol abuse, or smoking. Patients diagnosed with head and neck cancer experience many symptoms individually or in combination related to the disease and treatment. The main symptoms include fatigue, pain, weight loss, lack of appetite, dysphagia, dry mouth, decreased salivation, taste changes, and tooth problems. Speech therapy, nutrition, the maintenance of stoma, chewing and swallowing therapy, and pain management are the major components of the rehabilitation programs for patients with head and neck cancer. Health care professionals must use a interdisciplinary approach for the evaluation on patients to cope with functional and cosmetic problems. As a member of this team, rehabilitation nurses play a major role as case managers and also engage the patient and family into the treatment plan, providing education (tracheostomy maintenance and home exercises), improving self-care capabilities and selfsufficiency, preventing complications, and ensuring an optimum level of functionality. We suggest that the effective engagement of rehabilitation nurses into the treatment is helpful to alleviate symptoms and increase the quality of life of these patients.K Ke ey yw wo or rd ds s: : Head and neck neop...

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Predictors and outcomes for chronic tracheostomy after chemoradiation for advanced laryngohypopharyngeal cancer

Abstract: 4.

Cited by 19 publications

References 21 publications

Risk analysis for tracheostomy dependency in curatively treated laryngeal cancer with organ preservation

Risk analysis for tracheostomy dependency in curatively treated laryngeal cancer with organ preservation

Systematic review and meta‐analysis of transoral laser microsurgery in hypopharyngeal carcinoma

Rehabilitation Nursing in Head Neck Cancer Patients

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