Utility approach to decision-making in extended T1 and limited T2 glottic carcinoma

Loon, Yda van; Stiggelbout, Anne M.; Hakkesteegt, Marieke M.; Langeveld, Ton P. M.; Jong, Rob J. Baatenburg de; Sjögren, Elisabeth V.

doi:10.1002/hed.24689

Cited by 8 publications

(8 citation statements)

References 35 publications

(49 reference statements)

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“…A study by van Loon et al investigated the time trade off in patients with laryngeal cancer and concluded that none of the patients who were treated with TLM was prepared to trade off years to live in perfect health. This shows that the perceived side effects (e.g., dysphonia) by patients are not substantial and that patients are able to cope well with their limitations in daily life [37]. QoL is a multidimensional construct; thus, it is best measured with an instrument that reports on multiple domains of functionality and well-being.…”

Section: Discussionmentioning

confidence: 99%

Quality of life and voice outcome of patients treated with transoral CO2 laser microsurgery for early glottic carcinoma (T1–T2): a 2-year follow-up study

Hendriksma

Loon

Klop

et al. 2019

Eur Arch Otorhinolaryngol

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PurposeLongitudinal studies in laryngeal cancer can provide clinicians information about short-term and long-term functional outcomes, like quality of life (QoL) and voice outcome. This information is important when counseling patients or choosing a primary treatment modality. The present study assessed long-term (2 years) QoL and voice outcome in patients with extended T1 and limited T2 glottic carcinoma treated with transoral CO2 laser microsurgery (TLM) (unilateral type III or bilateral type II resections).MethodsThree questionnaires were administered: the Voice Handicap Index (VHI), the European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaire (QLQ)-C30, the EORTC QLQ-HN35. A perceptual voice evaluation at six different time points was conducted: preoperatively, and postoperatively at 6 weeks, 3 months, 6 months, 1 year, and 2 years. Fluctuations over time were investigated.ResultsSixty-one patients were included in the analysis. Patients reported high-level functioning and low symptom scores 2 years postoperatively. Gender significantly affected the VHI scores at 2 years (mean VHI scores: female 8.7 vs. male, 23.9; p = 0.023). The major improvement in VHI scores was observed within the first 6 months. The tumor stage (T1a, T1b, and T2) significantly impacted the grade (mean scores at 2 years: 1.0, 1.9, and 1.7; p = 0.001). These scores stabilized at 6 months.ConclusionsPatients show good long-term QoL with low symptom scores, a low voice handicap, and mild to moderate dysphonia, 2 years postoperatively. Scores stabilize at 6 months and provide a clear indication of status at 1 and 2 years.

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Section: Discussionmentioning

confidence: 99%

Quality of life and voice outcome of patients treated with transoral CO2 laser microsurgery for early glottic carcinoma (T1–T2): a 2-year follow-up study

Hendriksma

Loon

Klop

et al. 2019

Eur Arch Otorhinolaryngol

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“…20 On the other hand, the systematic review by Huang et.al reported the advantage of Radiotherapy as an increased maximum phonation time and reduced fundamental frequency.+7 But some of the studies showed no significant difference among the outcomes. 4,21 Looking over the recurrence rate, majority of the patients with Laser surgery had tumor recurrence within 9 months to 1 year 22 , while the patients treated with Radiotherapy showed lower recurrence with high disease-free survival 23 , but these findings are contradictory to current study that showed recurrence within 22 months in Radiotherapy treated patients. A Japanese study supported the findings of current study by reporting recurrence within 18 months among patients treated with Radiotherapy.…”

Section: Discussionmentioning

confidence: 61%

“…The recommended approaches for early stage glottic carcinoma are both laser surgery (LS) as well as radiotherapy (RT). [1][2][3][4] Comparison of both modalities reveals that Laser Surgery is predominant over Radiotherapy in local control of tumor along with preservation of laryngeal anatomy. 3,5,6 Both modalities having some merits as well as demerits like Laser Surgery is expensive, quick, inch-perfect and improvement in hemostasis but require surgical skills and feasibility on the other hand Radiotherapy require longer duration of treatment and the lesion follows the sequel of fibrosis and mucosal edema.…”

Section: Introductionmentioning

confidence: 99%

A novel modality to cure early glottic carcinoma

Baig

Shahid

Sadiq

et al. 2019

TPMJ

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Introduction: The current practice standards demand achievement of cure along with preservation of voice and laryngeal anatomy. The recommended approaches for early stage glottic carcinoma are both laser surgery (LS) as well as radiotherapy (RT). Both modalities having some merits as well as demerits. So the objective of the study is to compare the outcome of early glottic cancer patients having laser resection with the patients who received radiation therapy. Study Design: Cross sectional study. Setting: Ziauddin Hospital. Period: January 2013 up to July 2017. Material and Methods: Patients aged 18 years and above with a history of constant hoarseness of voice from 2 months to 4 months were taken. Only the patients with stage 1 that is T1a or T1b squamous cell carcinoma of vocal cords with no nodal or distant metastasis (T1N0M0) were included. Results: A total of 25 patients were diagnosed with glottic cancer of stage T1N0M0. The mean age was 50.56 ± 11.8. Most of them were male with high prevalence of aggravating factors. Majority of patients had left sided vocal cord involvement. When comparing the both modalities, the results showed that Radiotherapy had more complications than Laser surgery. On follow-up visits, the complication with Radiotherapy subsides and larynx anatomy restored but there was no voice restoration in Laser surgery. Conclusion: It can be concluded that both treatment modalities including Laser Surgery and Radiotherapy had excellent outcome with good prognosis for voice. However, considering the survival rates, Radiotherapy showed bit superiority over Laser Surgery, despite its complications. Radiotherapy should be the first choice after diagnosing early stage of glottic carcinoma.

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“…LS has plenty of unique advantages. It can achieve precise cutting, bloodless operation, short operation time, and significantly reduce the recurrence rate 11,18–20. Besides, the length of hospital stay will be shortened, and the cost of hospitalization is greatly reduced 21…”

Section: Discussionmentioning

confidence: 99%

The voice quality after laser surgery versus radiotherapy of T1a glottic carcinoma: systematic review and meta-analysis

Huang¹,

Luo²,

Zhang³

et al. 2017

OTT

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Background and objectivesThe voice quality assessment of laser surgery (LS) in comparison with radiotherapy (RT) remains uncertain in T1a glottic carcinoma treatment. This systematic review and meta-analysis were conducted to compare the voice quality of the two treatments.MethodsSearches were conducted in PubMed, EMBASE, and Cochrane with the following index words: glotti*, layn*, vocal cord, vocal, surgery, cordectomy, laser, radiation, irradiation, radiotherapy, cancer, and carcinoma for relative studies that compared the voice quality between LS and RT. Random-effect models were used, and heterogeneity was assessed.ResultsA total of 14 studies were included in the analysis, consisting of 1 randomized controlled trial, 1 prospective study, and 12 retrospective studies. RT has increased the maximum phonation time (MPT; mean difference [MD] =−1.89, 95% confidence interval [CI] =−3.66 to −0.11, P=0.04) and decreased the fundamental frequency (MD =14.06, 95% CI =10.30–17.83, P<0.00001) in comparison with LS. No statistical difference was observed between the two groups in terms of Voice Handicap Index, Jitter, Shimmer, and airflow rate.ConclusionRT may be a better choice for T1a glottic carcinoma treatment compared with LS because patients undergoing RT may have the advantage of increased MPT and decreased fundamental frequency. However, more multicenter, randomized, controlled trials are urgently needed to verify these differences.

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Utility approach to decision-making in extended T1 and limited T2 glottic carcinoma

Cited by 8 publications

References 35 publications

Quality of life and voice outcome of patients treated with transoral CO2 laser microsurgery for early glottic carcinoma (T1–T2): a 2-year follow-up study

Quality of life and voice outcome of patients treated with transoral CO2 laser microsurgery for early glottic carcinoma (T1–T2): a 2-year follow-up study

A novel modality to cure early glottic carcinoma

The voice quality after laser surgery versus radiotherapy of T1a glottic carcinoma: systematic review and meta-analysis

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