Relationship between the time to locoregional recurrence and survival in laryngeal squamous-cell carcinoma

Gorphe, Philippe; Tao, Yungan; Blanchard, Pierre; Even, Caroline; Moya‐Plana, Antoine; Mirghani, Haïtham; Temam, Stéphane; Janot, F.

doi:10.1007/s00405-017-4473-3

Cited by 9 publications

(7 citation statements)

References 17 publications

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“…The data extracted here (Appendix S1) confirmed the oncologic efficacy of primary TL reported in smaller series at shorter follow‐up 20–23 . Thus, the 10‐year local control estimate was 89.7% (Fig.…”

Section: Discussionsupporting

confidence: 80%

“…The data extracted here (Appendix S1) confirmed the oncologic efficacy of primary TL reported in smaller series at shorter follow-up. [20][21][22][23] Thus, the 10-year local control estimate was 89.7% (Fig. 3), while global local control after salvage of local recurrence was 92% and TL-related mortality was 3%, much lower than the 37%, 33%, and 28% 10-year mortality rates implicating index SCC progression, intercurrent disease and metachronous second primaries, respectively, after TL.…”

Section: Discussionmentioning

confidence: 93%

“…The first two concern the single-center and retrospective design, a limitation however found in almost all the 21st century literature on TL. [8][9][10][11]18,[21][22][23][24][25][26][27][28][29][30][31][32][33][34] The third, and doubtless most important, point concerns to a variety of treatments detailed in the section describing the study population (Table I), with TL performed by 54 different headand-neck surgeons (see Acknowledgments) over a period of 4 decades. However, the local recurrence rate seemed not to vary from decade to decade (Table II), relativizing this bias and suggesting that oncologic results, and notably local recurrence, after TL for endolaryngeal cT3-4 SCC are not operator-dependent.…”

Section: Discussionmentioning

confidence: 99%

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Primary Total Laryngectomy for Endolaryngeal cT3‐4M0 Squamous Cell Carcinoma: A STROBE Analysis

Laccourreye,

Garcia,

Haroun

et al. 2023

The Laryngoscope

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ObjectivesTo document 10‐year oncologic outcome of primary total laryngectomy (TL) for patients with cT3‐4M0 endolaryngeal squamous cell carcinoma (SCC).Study DesignObservational inception cohort of 531 patients with isolated untreated endolaryngeal cT3‐4M0 SCC review over 40 years using STROBE guideline. 94% of patients were followed until death or for a minimum of 10 years.SettingAcademic tertiary referral care center.MethodsAll patients underwent primary TL. Prior tracheotomy, induction chemotherapy, thyroid gland resection, level II‐IV neck dissection, level VI dissection, and postoperative radiation therapy were associated in 6%, 40%, 43%, 89%, 47%, and 74% of cases, respectively: The main objective was to determine the 10‐year actuarial local control estimate. Accessory objectives comprised screening for clinical variables increasing the risk of local recurrence, and analysis of long‐term oncologic consequences of local recurrence.ResultsThe 10‐year actuarial local control estimate was 89.7%. Local recurrence was salvaged in 11% of cases, resulting in 92% overall local control. On multivariate analysis, none of the study variables correlated with local recurrence. Local recurrence resulted in significantly reduced nodal control, distant metastasis control, and survival. Postoperative complications, persistent index SCC, intercurrent disease, and metachronous second primary cancer accounted for respectively 3%, 37%, 33%, and 28% of the 334 deaths noted during the 10 years following TL.ConclusionThe present study underscored the long‐term oncologic efficacy of primary TL, the dangers of local recurrence, the key role of local control for survival, and the importance of a long‐term oncologic watch policy.Level of Evidence3 Laryngoscope, 2023

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Primary Total Laryngectomy for Endolaryngeal cT3‐4M0 Squamous Cell Carcinoma: A STROBE Analysis

Laccourreye,

Garcia,

Haroun

et al. 2023

The Laryngoscope

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“…Survival is associated with the occurrence of recurrences, with the worst prognosis in the case of locoregional failure within the first year after treatment [ 6 ]. Data on recurrence rates for the different treatment strategies are controversial [ 7 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

The relation between hypoxia and proliferation biomarkers with radiosensitivity in locally advanced laryngeal cancer

Bovenkamp

Vegt

Halmos

et al. 2023

Eur Arch Otorhinolaryngol

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Purpose Treatment decision-making in advanced-stage laryngeal squamous cell carcinoma (LSCC) is difficult due to the high recurrence rates and the desire to preserve laryngeal functions. New predictive markers for radiosensitivity are needed to facilitate treatment choices. In early stage glottic LSCC treated with primary radiotherapy, expression of hypoxia (HIF-1α and CA-IX) and proliferation (Ki-67) tumour markers showed prognostic value for local control. The objective of this study is to examine the prognostic value of tumour markers for hypoxia and proliferation on locoregional recurrent disease and disease-specific mortality in a well-defined cohort of patients with locally advanced LSCC treated with primary, curatively intended radiotherapy. Methods In pre-treatment biopsy tissues from a homogeneous cohort of 61 patients with advanced stage (T3–T4, M0) LSCC primarily treated with radiotherapy, expression of HIF-1α, CA-IX and Ki-67 was evaluated with immunohistochemistry. Demographic data (age and sex) and clinical data (T- and N-status) were retrospectively collected from the medical records. Cox regression analysis was performed to assess the relation between marker expression, demographic and clinical data, and locoregional recurrence and disease-specific mortality. Results Patients with high expression of HIF-1α developed significantly more often a locoregional recurrence (39%) compared to patients with a low expression (21%) (p = 0.002). The expression of CA-IX and Ki-67 showed no association with locoregional recurrent disease. HIF-1α, CA-IX and Ki-67 were not significantly related to disease-specific mortality. Clinical N-status was an independent predictor of recurrent disease (p < 0.001) and disease-specific mortality (p = 0.003). Age, sex and T-status were not related to locoregional recurrent disease or disease-specific mortality. Conclusion HIF-1α overexpression and the presence of regional lymph node metastases at diagnosis were independent predictors of locoregional recurrent disease after primary treatment with curatively intended radiotherapy in patients with locally advanced LSCC.

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“…[10][11][12] In 2009, the larynx preservation clinical trial design consensus panel recommended a new endpoint: laryngo-esophageal dysfunction-free survival (LEDFS) to be the primary endpoint for future laryngeal preservation trials. 13 Events for this composite endpoint were; death, local failure (LF), total or partial laryngectomy, tracheotomy, or feeding tube dependency, however, regional failure (RF) and distant metastases (DM) were not included as events, despite that RF and DM are determinant in prognosis for laryngeal cancer patients, [14][15][16][17] and representing important events in laryngeal cancer outcomes trajectory. Therefore, we propose to have a new composite endpoint which encompass the survival (i.e., death), tumor relapse (i.e., LF, RF, and DM), and laryngo-esophageal dysfunction (i.e., speech and swallowing).…”

Section: Introductionmentioning

confidence: 99%

Primary radiation therapy for advanced‐stage laryngeal cancer: A laryngo‐esophageal dysfunction disease‐free survival

Mohamad

Almousa

Taqash

et al. 2022

Laryngoscope Investig Oto

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Objectives: To evaluate the outcomes of advanced-stage laryngeal squamous cell carcinoma (SCC) patients treated with functional-preservation strategy with a specific focus on laryngo-esophageal dysfunction disease-free survival (LEDDFS).Methods and materials: A retrospective review was conducted of stage III-IVB laryngeal SCC patients who were treated with curative-intent radiotherapy (RT) (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018). Patients were preferentially managed with upfront chemoradiation (CCRT); except for those with cN2-3, cT4, or large volume cT3 (induction chemotherapy followed by RT or CCRT is an option), and those who were unfit or declined chemotherapy (received altered RT). The primary endpoint was 3-year LEDDFS, and secondary endpoints were 3-year local failure (LF), regional failure (RF), distant metastasis (DM), overall survival (OS), disease-free survival (DFS), and acute and late toxicities. Cox proportional hazard tests were used for multivariable analysis (MVA).Results: A total of 213 cases were included. With a median follow-up of 37 months, the 3-year LEDDFS was 50%, while the 3-year OS, DFS, LF, RF, and DM were 81%, 74%, 9%, 5%, and 7%, respectively. On MVA, cT4-category was the only predictor of inferior LEDDFS (HR: 0.47, [95% CI: 0.29-0.74], p < .01). The most common grade ≥ 3 acute and late radiation therapy oncology group (RTOG) toxicity were esophageal toxicity: 16.7% and 29.6%, respectively.Conclusions: Primary RT resulted in favorable oncologic and functional outcomes in only half of the advanced-stage laryngeal cancer patients. Future clinical trials are required to investigate further treatment options aiming to improve the oncologic and maintain functional outcomes with utilization of LEDDFS as the primary endpoint.

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Relationship between the time to locoregional recurrence and survival in laryngeal squamous-cell carcinoma

Cited by 9 publications

References 17 publications

Primary Total Laryngectomy for Endolaryngeal cT3‐4M0 Squamous Cell Carcinoma: A STROBE Analysis

Primary Total Laryngectomy for Endolaryngeal cT3‐4M0 Squamous Cell Carcinoma: A STROBE Analysis

The relation between hypoxia and proliferation biomarkers with radiosensitivity in locally advanced laryngeal cancer

Primary radiation therapy for advanced‐stage laryngeal cancer: A laryngo‐esophageal dysfunction disease‐free survival

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