Swallowing outcomes following surgical and non-surgical treatment for advanced laryngeal cancer

Burnip, Emma; Owen, S; Barker, Sarah; Patterson, Joanne

doi:10.1017/s0022215113002478

Cited by 31 publications

(39 citation statements)

References 30 publications

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“…20,21 A comparison of functional outcomes from previous studies is difficult because the assessment measures were not standardized. 18,19,32,33 …”

Section: Discussionmentioning

confidence: 99%

“…Gastrostomy dependence indicated significant swallowing dysfunction that required supplementation through a gastrostomy tube. Tracheostomy tube dependence was higher among patients receiving CRT, which may reflect more severe tissue damage caused by adding CT. Two independent studies 32,33 found that patients with advanced laryngeal cancer receiving RT or surgery had minimal swallowing problems; however, they had worse swallowing outcomes if they received CRT and CRT plus surgery.…”

Section: Discussionmentioning

confidence: 99%

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Surgical vs Nonsurgical Treatment Modalities for T3 Glottic Squamous Cell Carcinoma

Al‐Gilani

Skillington

Kallogjeri

et al. 2016

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE Further investigation is needed in the outcomes of currently available treatment for T3 glottic squamous cell carcinoma (SCC), a unique type of laryngeal cancer. OBJECTIVE To compare overall survival (OS) and functional outcomes among patients with T3 glottic SCC receiving nonsurgical and surgical management. DESIGN, SETTING, AND PARTICIPANTS This secondary analysis used data from the Surveillance, Epidemiology, and End Results (SEER) registry and Medicare databases. All patients with T3 glottic SCC who received a diagnosis from January 1, 1992, to December 31, 2010, were included. Data were analyzed from April 2014 to August 2015. INTERVENTIONS Surgery with or without adjuvant radiotherapy and/or chemotherapy. MAIN OUTCOMES AND MEASURES Five-year OS and functional outcomes. RESULTS Among the 487 patients identified with T3 glottic SCC (418 men [85.8%]; 69 women [14.2%]; median age, 74.3 [interquartile range, 70.4–80.6] years), the 5-year OS for nonsurgical management, surgery alone, and surgery plus adjuvant treatment were 36% (95% CI, 30%–42%), 41% (95% CI, 30%–53%), and 41% (95% CI, 32%–51%), respectively. Multivariable analyses revealed an adjusted hazard ratio for OS of 0.68 (95% CI, 0.49–0.94) for patients receiving surgery alone vs nonsurgical management and 0.75 (95% CI, 0.57–0.98) for patients receiving surgery plus adjuvant treatment vs nonsurgical management. Gastrostomy tube dependence was highest in patients receiving surgery plus adjuvant treatment (30 of 98 patients [30.6%]). Tracheostomy dependence was highest in patients receiving chemoradiotherapy (34 of 92 patients [37.0%]). CONCLUSIONS AND RELEVANCE Overall survival showed a statistically significant and clinically meaningful improvement in patients with T3 glottic SCC who underwent surgery compared with a nonsurgical treatment. Furthermore, the data suggest that adjuvant and nonsurgical treatment result in a dysfunctional larynx; however, this association needs further study.

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“…20,21 A comparison of functional outcomes from previous studies is difficult because the assessment measures were not standardized. 18,19,32,33 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgical vs Nonsurgical Treatment Modalities for T3 Glottic Squamous Cell Carcinoma

Al‐Gilani

Skillington

Kallogjeri

et al. 2016

JAMA Otolaryngol Head Neck Surg

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show abstract

“…4,6,8,9,11 Although highest in the treatment and early follow-up phase, 2,8-10 supportive care needs may remain through the long-term follow-up. [14][15][16] In addition, they have often been treated with (chemo)radiation and/or neck dissection, which may induce problems, such as dysphagia and shoulder complaints. These patients encounter several adjustments in normal daily functioning, which they have to live with for the rest of their lives, including adjustments in airway management, smell, swallowing, and speech.…”

Section: Introductionmentioning

confidence: 99%

Unmet supportive care needs in patients treated with total laryngectomy and its associated factors

et al. 2018

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Background The purpose of this study was to investigate unmet supportive care needs in patients treated with total laryngectomy and its associated factors. Methods In this cross‐sectional study, 283 patients who underwent total laryngectomy completed questions on supportive care needs (Supportive Care Needs Survey [SCNS]). Median time since total laryngectomy surgery was 7 years (range 0‐37 years). The prevalence of unmet supportive care needs and its associated factors were investigated using logistic regression analyses. Results Unmet supportive care needs were highest for the head and neck cancer‐specific functioning domain (53%), followed by the psychological (39%), physical and daily living (37%), health system, information, and patient support (35%), sexuality (23%), and lifestyle (5%) domains. Seventy‐one percent reported at least one low, moderate, or high unmet need. Female sex, living alone, and having a voice prosthesis were positively associated with unmet needs on 1 domain (P < .05). A worse health‐related quality of life was associated with unmet needs on all domains. Conclusion The majority of patients who underwent total laryngectomy report at least one low, moderate, or high unmet supportive care need.

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“…Patients who received primary radiochemotherapy for organ preservation have significantly higher dysphagia rates compared to laryngectomees [142], [149]. Furthermore, patients after total laryngectomy alone have better swallowing function than patients after total laryngectomy and adjuvant radiation or salvage laryngectomy [145], [153], [154]. …”

Section: Therapy Of Primarily Diagnosed Laryngeal Cancermentioning

confidence: 99%

Evidence and evidence gaps of laryngeal cancer surgery

Wiegand

2016

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 15:Doc03

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Swallowing outcomes following surgical and non-surgical treatment for advanced laryngeal cancer

Cited by 31 publications

References 30 publications

Surgical vs Nonsurgical Treatment Modalities for T3 Glottic Squamous Cell Carcinoma

Surgical vs Nonsurgical Treatment Modalities for T3 Glottic Squamous Cell Carcinoma

Unmet supportive care needs in patients treated with total laryngectomy and its associated factors

Evidence and evidence gaps of laryngeal cancer surgery

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