Supracricoid Partial Laryngectomy After Failed Laryngeal Radiation Therapy

Laccourreye, O.; Weinstein, Gregory S.; Naudo, Philippe; Cauchois, R.; Laccourrèye, H; Brasnu, Daniel

doi:10.1097/00005537-199604000-00019

Cited by 132 publications

(149 citation statements)

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“…[20][21][22] Laccourreye et al 20 reported an excellent local control rate (98.2% at 5 years) in cases of T1 to T2 glottic carcinoma with extension to the anterior commissure treated with SCPL. Chevalier and Piquet, 21 in a review of 61 patients with supraglottic squamous cell carcinoma classified as T1 to T4, reported a 97% local control rate after CHP.…”

Section: Commentmentioning

confidence: 99%

“…Recently, SCPL was also reported to be a possible modality of laryngeal preservation treatment in selected patients with local failure after laryngeal radiation therapy. 22 Such data led Bridger 23 to assert that "in the near future any patient being evaluated for total laryngectomy should be considered for the less radical supracricoid partial laryngectomies. "…”

Section: Commentmentioning

confidence: 99%

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Supracricoid Partial Laryngectomy in the Treatment of Laryngeal Cancer

Gallo¹,

Manciocco²,

Simonelli³

et al. 2005

Arch Otolaryngol Head Neck Surg

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Objectives: To evaluate the oncological results of supracricoid partial laryngectomy as a treatment for selected glottic and supraglottic cancer in a large series of patients who had undergone uniform treatment over a 16-year period and to determine the different prognostic factors that may influence local control and survival.Design: Retrospective clinical study.Setting: Academic tertiary referral medical center. Patients:The study population comprised 253 consecutive patients (234 men and 19 women) with glottic and supraglottic squamous cell carcinoma. The mean age was 58 years for men and 59.2 years for women.Intervention: Supracricoid partial laryngectomy: 180 patients had undergone cricohyoidopexy and 73 had undergone cricohyoidoepiglottopexy.Main Outcome Measures: Local control and overall survival. Potential prognostic factors for local control and survival were evaluated with univariate and multivariate models.Results: The 3-, 5-, 10-, and 16-year overall survival rates in this group of 253 patients were 85.8%, 79.1%, 57.6%, and 57.6%, respectively. With regard to local control, univariate and multivariate analyses showed that a positive resection margin was the only important predictor of local control and that a dysplastic lesion at the margin of resection is just as aggressive as the presence of invasive carcinoma. When considering the prognostic factors influencing survival, univariate analysis showed that the tumor category, lymph node category, tumor stage, and recurrence all had a significant influence on the survival rate. Multivariate analysis showed that the most important predictor of survival was recurrence.Conclusions: Supracricoid partial laryngectomy is a valid choice in the treatment of selected glottic and supraglottic cancer while maintaining laryngeal functions and achieving a high rate of local control. T category, N category, tumor stage, positive resection margins, and recurrence are the most important predictors of oncological outcome.

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Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Supracricoid Partial Laryngectomy in the Treatment of Laryngeal Cancer

Gallo¹,

Manciocco²,

Simonelli³

et al. 2005

Arch Otolaryngol Head Neck Surg

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“…Since second mid-nineties, several authors [5,10,11] have proposed in selected cases salvage partial laryngectomies (SPLs), that include supracricoid partial laryngectomy (SCPL, such as cricohyoidopexy, cricohyoidoepiglottopexy, tracheohyoidopexy, tracheohyoidoepiglottopexy) and endoscopic CO2 laser cordectomy, as an alternative to STL in the treatment of laryngeal recurrence after RT, allowing to preserve laryngeal functions [10]. Even if the common indications for salvage laryngeal surgery after radiotherapy treatment are the same of those recommended for primary laryngeal cancer treatment, the correct staging of the recurrent tumour is the real challenge to select the most suitable surgical indication.…”

Section: Introductionmentioning

confidence: 99%

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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“…[22][23][24][25] SCPLs (including both SCPL with cricohyoidoepiglottopexy, or CHEP, and SCPL with cricohyoidopexy, or CHP) can be adopted in many mid-sized laryngeal cancers, strictly respecting tumor-and patient-related indications. 24 The aim of this study was to retrospectively evaluate the oncologic and functional outcomes as well as the complication rate in a multi-institutional Italian cohort of 78 consecutive patients who underwent SCPLs with CHP or CHEP as salvage treatment after RT failure.…”

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confidence: 99%