A multidisciplinary team guided approach to the management of cT3 laryngeal cancer: A retrospective analysis of 104 cases

Filippo Marchi, Marta Filauro, Francesco Missale, Giampiero Parrinello, Fabiola Incandela, Almalina Bacigalupo, Stefania Vecchio, Cesare Piazza, Giorgio Peretti

Research output: Contribution to journalArticle

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 languageEnglish
Article number717
JournalCancers
Volume11
Issue number5
DOIs
Publication statusPublished - May 1 2019

Fingerprint

Laryngeal Neoplasms
Laryngectomy
Microsurgery
Disease-Free Survival
Lasers
Radiotherapy
Therapeutics
Radiation
Organ Preservation
Head and Neck Neoplasms
Tertiary Care Centers
Carcinoma

Keywords

  • Head and neck cancer
  • Laryngeal cancer
  • Laryngeal neoplasm
  • Laryngo-esophageal disfunction
  • Multidisciplinary team
  • Prognosis

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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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 journalArticle

Marchi, Filippo ; Filauro, Marta ; Missale, Francesco ; Parrinello, Giampiero ; Incandela, Fabiola ; Bacigalupo, Almalina ; Vecchio, Stefania ; Piazza, Cesare ; Peretti, Giorgio. / A multidisciplinary team guided approach to the management of cT3 laryngeal cancer : A retrospective analysis of 104 cases. In: Cancers. 2019 ; Vol. 11, No. 5.
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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.",
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AU - Parrinello, Giampiero

AU - Incandela, Fabiola

AU - Bacigalupo, Almalina

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