Abstract
The optimal treatment for T3 laryngeal carcinoma (LC) is still a matter of debate. Different therapeutic options are available: Transoral laser microsurgery (TLM), open partial horizontal laryngectomies (OPHLs), total laryngectomy (TL), and organ preservation protocols (radiation therapy (RT) or chemo-radiation (CRT)). This study aimed to retrospectively evaluate oncologic outcomes of 104 T3 LCs treated by surgery or non-surgical approaches from January 2011 to December 2016 at a single academic tertiary referral center. Each case was evaluated by a multidisciplinary team (MDT) devoted to the management of head and neck cancers. We divided the cohort into two subgroups: Group A, surgical treatment (TLM, OPHLs, TL) and Group B, non-surgical treatment (RT, CRT). For the entire cohort, two-and five-year overall survival (OS) rates were 83% and 56%, respectively. The two-and five-year disease-free survival (DFS) rates were 75% and 65%, and disease-specific survival rates were 93% and 70%, respectively. The N category was a significant independent prognosticator for OS (p = 0.02), whereas Group B was significantly and independently associated with DFS (HR 4.10, p = 0.006). Analyzing laryngo-esophageal dysfunction-free survival as an outcome, it was found that this was significantly lower in higher N categories (p = 0.04) and in cases that underwent non-surgical treatments (p = 0.002). Optimization of oncologic outcomes in T3 LCs may be obtained only by a comprehensive MDT approach, considering that different treatment options have heterogenous toxicity profiles and indications.
| Original language | English |
|---|---|
| Article number | 717 |
| Journal | Cancers |
| Volume | 11 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 1 2019 |
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Keywords
- Head and neck cancer
- Laryngeal cancer
- Laryngeal neoplasm
- Laryngo-esophageal disfunction
- Multidisciplinary team
- Prognosis
ASJC Scopus subject areas
- Oncology
- Cancer Research
Cite this
A multidisciplinary team guided approach to the management of cT3 laryngeal cancer : A retrospective analysis of 104 cases. / Marchi, Filippo; Filauro, Marta; Missale, Francesco; Parrinello, Giampiero; Incandela, Fabiola; Bacigalupo, Almalina; Vecchio, Stefania; Piazza, Cesare; Peretti, Giorgio.
In: Cancers, Vol. 11, No. 5, 717, 01.05.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A multidisciplinary team guided approach to the management of cT3 laryngeal cancer
T2 - A retrospective analysis of 104 cases
AU - Marchi, Filippo
AU - Filauro, Marta
AU - Missale, Francesco
AU - Parrinello, Giampiero
AU - Incandela, Fabiola
AU - Bacigalupo, Almalina
AU - Vecchio, Stefania
AU - Piazza, Cesare
AU - Peretti, Giorgio
PY - 2019/5/1
Y1 - 2019/5/1
N2 - The optimal treatment for T3 laryngeal carcinoma (LC) is still a matter of debate. Different therapeutic options are available: Transoral laser microsurgery (TLM), open partial horizontal laryngectomies (OPHLs), total laryngectomy (TL), and organ preservation protocols (radiation therapy (RT) or chemo-radiation (CRT)). This study aimed to retrospectively evaluate oncologic outcomes of 104 T3 LCs treated by surgery or non-surgical approaches from January 2011 to December 2016 at a single academic tertiary referral center. Each case was evaluated by a multidisciplinary team (MDT) devoted to the management of head and neck cancers. We divided the cohort into two subgroups: Group A, surgical treatment (TLM, OPHLs, TL) and Group B, non-surgical treatment (RT, CRT). For the entire cohort, two-and five-year overall survival (OS) rates were 83% and 56%, respectively. The two-and five-year disease-free survival (DFS) rates were 75% and 65%, and disease-specific survival rates were 93% and 70%, respectively. The N category was a significant independent prognosticator for OS (p = 0.02), whereas Group B was significantly and independently associated with DFS (HR 4.10, p = 0.006). Analyzing laryngo-esophageal dysfunction-free survival as an outcome, it was found that this was significantly lower in higher N categories (p = 0.04) and in cases that underwent non-surgical treatments (p = 0.002). Optimization of oncologic outcomes in T3 LCs may be obtained only by a comprehensive MDT approach, considering that different treatment options have heterogenous toxicity profiles and indications.
AB - The optimal treatment for T3 laryngeal carcinoma (LC) is still a matter of debate. Different therapeutic options are available: Transoral laser microsurgery (TLM), open partial horizontal laryngectomies (OPHLs), total laryngectomy (TL), and organ preservation protocols (radiation therapy (RT) or chemo-radiation (CRT)). This study aimed to retrospectively evaluate oncologic outcomes of 104 T3 LCs treated by surgery or non-surgical approaches from January 2011 to December 2016 at a single academic tertiary referral center. Each case was evaluated by a multidisciplinary team (MDT) devoted to the management of head and neck cancers. We divided the cohort into two subgroups: Group A, surgical treatment (TLM, OPHLs, TL) and Group B, non-surgical treatment (RT, CRT). For the entire cohort, two-and five-year overall survival (OS) rates were 83% and 56%, respectively. The two-and five-year disease-free survival (DFS) rates were 75% and 65%, and disease-specific survival rates were 93% and 70%, respectively. The N category was a significant independent prognosticator for OS (p = 0.02), whereas Group B was significantly and independently associated with DFS (HR 4.10, p = 0.006). Analyzing laryngo-esophageal dysfunction-free survival as an outcome, it was found that this was significantly lower in higher N categories (p = 0.04) and in cases that underwent non-surgical treatments (p = 0.002). Optimization of oncologic outcomes in T3 LCs may be obtained only by a comprehensive MDT approach, considering that different treatment options have heterogenous toxicity profiles and indications.
KW - Head and neck cancer
KW - Laryngeal cancer
KW - Laryngeal neoplasm
KW - Laryngo-esophageal disfunction
KW - Multidisciplinary team
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85067193559&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85067193559&partnerID=8YFLogxK
U2 - 10.3390/cancers11050717
DO - 10.3390/cancers11050717
M3 - Article
AN - SCOPUS:85067193559
VL - 11
JO - Cancers
JF - Cancers
SN - 2072-6694
IS - 5
M1 - 717
ER -