Treatment outcomes of laryngectomy compared to non-surgical management of T₃ laryngeal carcinomas: a 10-year multicentre audit of 179 patients in the northeast of England

Abstract

ObjectiveWide-ranging outcomes have been reported for surgical and non-surgical management of T3 laryngeal carcinomas. This study compared the outcomes of T3 tumours treated with laryngectomy or (chemo)radiotherapy in the northeast of England.MethodsThe outcomes of T3 laryngeal carcinoma treatment at three centres (2007–2016) were retrospectively analysed using descriptive statistics and survival curves.ResultsOf 179 T3 laryngeal carcinomas, 68 were treated with laryngectomies, 57 with chemoradiotherapy and 32 with radiotherapy. There was no significant five-year survival difference between treatment with laryngectomy (34.1 per cent) and chemoradiotherapy (48.6 per cent) (p = 0.184). The five-year overall survival rate for radiotherapy (12.5 per cent) was significantly inferior compared to laryngectomy and chemoradiotherapy (p = 0.003 and p < 0.001, respectively). The recurrence rates were 22.1 per cent for laryngectomy, 17.5 per cent for chemoradiotherapy and 50 per cent for radiotherapy. There were significant differences in recurrence rates when laryngectomy (p = 0.005) and chemoradiotherapy (p = 0.001) were compared to radiotherapy.ConclusionLaryngectomy and chemoradiotherapy had significantly higher five-year overall survival and lower recurrence rates compared with radiotherapy alone. Laryngectomy should be considered in patients unsuitable for chemotherapy, as it may convey a significant survival advantage over radiotherapy alone.

Quality of Life in a Patient with Total Laryngectomy Without Neck Dissection for Stage III Laryngeal Carcinoma

“…Based on the previous study, there are several surgical procedures for laryngeal cancer such as hemilaryngectomy, supraglottic laryngectomy, supracricoid laryngectomy, near total laryngectomy and total laryngectomy were accompanied by neck dissection [13]. For T3 laryngeal cancer, laryngectomy and chemoradiation was meet a better overcome compare to radiation alone [14]. Other study among 451 patients with malignant laryngeal tumors from 1985-2002 found a 5-year survival rate at stage I 85%, stage II 77 %, stage III 51% and stage IV 35% [15].…”

Organerhalt: Entscheidungskriterien für Patienten mit T3-Larynxkarzinom

“…fanden im Nordosten Englands beim T3-Larynxkarzinom ein signifikant schlechteres Überleben nach alleiniger pRT im Vergleich zur pCRT. Aufgrund dieser Erfahrung empfahlen die Autoren den Patienten die konkreten Überlebenszahlen vor Augen zu führen, um sie in der Entscheidung für die primäre TL zu motivieren: die 5‑Jahres-Überlebensrate nach alleiniger pRT lag bei 13 % im Vergleich zu 48 % nach pCRT [ 47 ]. Allerdings kumulieren ohne Randomisierung bei den konservativ behandelten Patienten (insbesondere denen, die ohne Chemotherapie behandelt wurden) alte und multimorbide Patienten und nichtresektable Tumoren.…”