Prevention of stomal recurrence

León, Xavier; Quer, Miquel; Burgués, Joaquim; Abelló, Pere; Vega, Manuel de; Andrés, Luis de

doi:10.1002/(sici)1097-0347(199601/02)18:1<54::aid-hed7>3.0.co;2-y

Cited by 46 publications

(24 citation statements)

References 32 publications

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“…Vrabec [6] 100/14% 46/22% 50/66% Posner [8] 20/30% 20/35% 3/100% Buisset [2] -20/20% 12/58% Grande [5] 50/24% 144/40% 27/81% Turner [14] --14/79% Sinard [10] 61/5% 108/11% 29/48% Total 231/15% 338/27% 135/67% therapy or surgery not including hemithyroidectomy, with a mean risk of hypothyroidism of 15% (range 5-30%). A second group, with an intermediate risk, is composed of patients treated with a combined treatment of surgery not including hemithyroidectomy and radiotherapy, with a mean risk of hypothyroidism of 27% (range 11-40%).…”

Section: Discussionmentioning

confidence: 99%

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Hypothyroidism in patients treated with total laryngectomy. A multivariate study

Lóon

Gras

Pérez

et al. 2002

European Archives of Oto-Rhino-Laryngology

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One of the complications of the treatment of head and neck carcinoma patients is hypothyroidism. The objective of our study was to quantify the prevalence of hypothyroidism in patients with laryngeal or hypopharyngeal cancer treated with a total laryngectomy and to evaluate the importance of different variables in the appearance of hypothyroidism in this group of patients. A transversal study in 182 patients treated with total laryngectomy between 1986 and 1998 was carried out. TSH and FT4 were determined in all patients. Hypothyroidism was classified as subclinical (increased TSH and normal T4 levels) and clinical (increased TSH and decreased T4 levels). Univariate and multivariate analysis was carried out to examine the relationship between hypothyroidism and different variables. Our results showed that the prevalence of hypothyroidism in our group of patients was 52% (27% subclinical and 25% clinical). Sex, initial extension of the tumour, hemithyroidectomy, use of chemotherapy and radiotherapy were variables associated with the appearance of hypothyroidism in the univariate analysis (P < 0.05). When all these variables were included in a multivariate study, only hemithyroidectomy (RR 3,6; CI 95% 1,7-7,2) and combined treatment with radiotherapy (RR 3,4; CI 95% 1,2-9,6) appeared as prognostic factors. In conclusion, hypothyroidism is a frequent complication in patients treated with a total laryngectomy (52%), especially when this treatment includes hemithyroidectomy and/or radiotherapy. We consider that it is important to check the thyroid function periodically in these patients to obtain early diagnosis and appropriate treatment.

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Section: Discussionmentioning

confidence: 99%

“…Surgery consisted in all cases of total laryngectomy with uni-or bilateral neck dissection. In patients with a locally advanced (T3-T4) glotto-subglottic or pyriform sinus tumour, a hemithyroidectomy and a paratracheal dissection were carried out [6].…”

Section: Methodsmentioning

confidence: 99%

Hypothyroidism in patients treated with total laryngectomy. A multivariate study

Lóon

Gras

Pérez

et al. 2002

European Archives of Oto-Rhino-Laryngology

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“…The most frequent site of the recurrences is at the peristomal level. Most authors consider the peristomal recurrence to be node metastasis of the paratracheal chain [1,2,8,12,16,25]. Indeed, Welsh [26] studied the laryngeal lymphatic network with a radioactive tracer and detected 96% of the tracer in the paratracheal lymph nodes when he injected it into one side of the subglottic larynx.…”

Section: Discussionmentioning

confidence: 99%

Primary carcinoma of the subglottic larynx

Santoro

Turelli

Polli

2000

European Archives of Oto-Rhino-Laryngology

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Primary cancer of the subglottic region is very rare and delay in diagnosis often leads to a poor prognosis. We retrospectively reviewed 49 patients with primary cancer of the subglottic larynx observed from 1969 to 1993 in the ORL Clinic of the University of Florence. This number constitutes 1.6% of all laryngeal cancers observed during this period. Four (8.2%) patients were stage T1, 13 (26.5%) T2, 27 (55.1%) T3, and 5 (10.2%) T4. Forty-one patients were eligible for assessing the disease-free five-year survival rate, 17 of whom were treated with surgery alone, 6 with radiotherapy alone and 18 with combination therapy (surgery for the primary tumor and postoperative radiotherapy for cervical nodes). The five-year survival rate for the three treatment types was 47%, 0% and 83.3%, respectively. The overall survival rate was 56.1%. Combination therapy produced a significantly higher (P = 0.001) disease-free survival than surgery alone or radiotherapy alone.

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“…None were treated with surgery. Leó n et al (51) reported six patients treated with radiotherapy or chemotherapy. All six died within the rst year as a consequence of tumor.…”

Section: Resultsmentioning

confidence: 99%