What is the price of functional surgical organ preservation in local-regionally advanced supraglottic cancer? Long-term outcome for partial laryngectomy followed by radiotherapy in 32 patients

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Abstract

Aims and background. To achieve the goal of organ preservation, both a chemoradiotherapy and a conservative surgical approach can be proposed. The aim of the study was to review all patients treated in our Institute with conservative surgery and postoperative radiotherapy for locally advanced supraglottic tumor. Methods and study design. A retrospective analysis of 32 patients treated between 2000 and 2010 was performed. Overall survival, disease-free survival and late laryngeal toxicity were evaluated. The impact of surgical procedures, radiotherapy characteristics and addition of chemotherapy on late laryngeal toxicity was studied. Results. The median follow-up was 38 months. Overall survival and disease-free survival at 5 years were 73% and 66%, respectively. Three (9%) patients experienced local recurrence (after 22, 25 and 40 months, respectively) and were treated with total laryngectomy. The larynx preservation rate was 93%. Severe treatment-related late laryngeal toxicity (grade 3 and 4 laryngeal edema, laryngeal stenosis, presence of tracheotomy at last follow-up because of treatment-related toxicity, and the need for enteral nutrition) was experienced by 34% of patients. The functional larynx preservation rate was 81%. The statistically significant risk factors for severe late toxicity were: female gender, extension of the surgical procedure, removal of one arytenoid and association with concomitant chemotherapy. Conclusions. We confirmed literature data on the feasibility and efficacy of a surgical organ preservation strategy. However, the high incidence of severe late toxicity requires further studies to improve patient selection and to reduce side effects. Copyright - Il Pensiero Scientifico Editore.

Original languageEnglish
Pages (from-to)667-675
Number of pages9
JournalTumori
Volume99
Issue number6
DOIs
Publication statusPublished - Nov 2013

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Organ Preservation
Laryngectomy
Radiotherapy
Larynx
Disease-Free Survival
Neoplasms
Laryngeal Edema
Laryngostenosis
Drug Therapy
Tracheotomy
Survival
Enteral Nutrition
Chemoradiotherapy
Patient Selection
Recurrence
Incidence
Therapeutics

Keywords

  • Concomitant chemoradiotherapy
  • Conservative surgery
  • Functional organ preservation
  • Laryngeal cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

@article{b0cd79a317c9406fb0f91e6eb018471b,
title = "What is the price of functional surgical organ preservation in local-regionally advanced supraglottic cancer? Long-term outcome for partial laryngectomy followed by radiotherapy in 32 patients",
abstract = "Aims and background. To achieve the goal of organ preservation, both a chemoradiotherapy and a conservative surgical approach can be proposed. The aim of the study was to review all patients treated in our Institute with conservative surgery and postoperative radiotherapy for locally advanced supraglottic tumor. Methods and study design. A retrospective analysis of 32 patients treated between 2000 and 2010 was performed. Overall survival, disease-free survival and late laryngeal toxicity were evaluated. The impact of surgical procedures, radiotherapy characteristics and addition of chemotherapy on late laryngeal toxicity was studied. Results. The median follow-up was 38 months. Overall survival and disease-free survival at 5 years were 73{\%} and 66{\%}, respectively. Three (9{\%}) patients experienced local recurrence (after 22, 25 and 40 months, respectively) and were treated with total laryngectomy. The larynx preservation rate was 93{\%}. Severe treatment-related late laryngeal toxicity (grade 3 and 4 laryngeal edema, laryngeal stenosis, presence of tracheotomy at last follow-up because of treatment-related toxicity, and the need for enteral nutrition) was experienced by 34{\%} of patients. The functional larynx preservation rate was 81{\%}. The statistically significant risk factors for severe late toxicity were: female gender, extension of the surgical procedure, removal of one arytenoid and association with concomitant chemotherapy. Conclusions. We confirmed literature data on the feasibility and efficacy of a surgical organ preservation strategy. However, the high incidence of severe late toxicity requires further studies to improve patient selection and to reduce side effects. Copyright - Il Pensiero Scientifico Editore.",
keywords = "Concomitant chemoradiotherapy, Conservative surgery, Functional organ preservation, Laryngeal cancer",
author = "Daniela Alterio and Mohssen Ansarin and Jereczek-Fossa, {Barbara A.} and Stefano Zorzi and Luigi Santoro and Dario Zerini and Mariangela Massaro and Elena Rondi and Silvia Ferrario and Gaia Piperno and Rocca, {Maria Cossu} and Mara Griseri and Lorenzo Preda and Fausto Chiesa and Roberto Orecchia",
year = "2013",
month = "11",
doi = "10.1700/1390.15454",
language = "English",
volume = "99",
pages = "667--675",
journal = "Tumori",
issn = "0300-8916",
publisher = "SAGE Publications Ltd",
number = "6",

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TY - JOUR

T1 - What is the price of functional surgical organ preservation in local-regionally advanced supraglottic cancer? Long-term outcome for partial laryngectomy followed by radiotherapy in 32 patients

AU - Alterio, Daniela

AU - Ansarin, Mohssen

AU - Jereczek-Fossa, Barbara A.

AU - Zorzi, Stefano

AU - Santoro, Luigi

AU - Zerini, Dario

AU - Massaro, Mariangela

AU - Rondi, Elena

AU - Ferrario, Silvia

AU - Piperno, Gaia

AU - Rocca, Maria Cossu

AU - Griseri, Mara

AU - Preda, Lorenzo

AU - Chiesa, Fausto

AU - Orecchia, Roberto

PY - 2013/11

Y1 - 2013/11

N2 - Aims and background. To achieve the goal of organ preservation, both a chemoradiotherapy and a conservative surgical approach can be proposed. The aim of the study was to review all patients treated in our Institute with conservative surgery and postoperative radiotherapy for locally advanced supraglottic tumor. Methods and study design. A retrospective analysis of 32 patients treated between 2000 and 2010 was performed. Overall survival, disease-free survival and late laryngeal toxicity were evaluated. The impact of surgical procedures, radiotherapy characteristics and addition of chemotherapy on late laryngeal toxicity was studied. Results. The median follow-up was 38 months. Overall survival and disease-free survival at 5 years were 73% and 66%, respectively. Three (9%) patients experienced local recurrence (after 22, 25 and 40 months, respectively) and were treated with total laryngectomy. The larynx preservation rate was 93%. Severe treatment-related late laryngeal toxicity (grade 3 and 4 laryngeal edema, laryngeal stenosis, presence of tracheotomy at last follow-up because of treatment-related toxicity, and the need for enteral nutrition) was experienced by 34% of patients. The functional larynx preservation rate was 81%. The statistically significant risk factors for severe late toxicity were: female gender, extension of the surgical procedure, removal of one arytenoid and association with concomitant chemotherapy. Conclusions. We confirmed literature data on the feasibility and efficacy of a surgical organ preservation strategy. However, the high incidence of severe late toxicity requires further studies to improve patient selection and to reduce side effects. Copyright - Il Pensiero Scientifico Editore.

AB - Aims and background. To achieve the goal of organ preservation, both a chemoradiotherapy and a conservative surgical approach can be proposed. The aim of the study was to review all patients treated in our Institute with conservative surgery and postoperative radiotherapy for locally advanced supraglottic tumor. Methods and study design. A retrospective analysis of 32 patients treated between 2000 and 2010 was performed. Overall survival, disease-free survival and late laryngeal toxicity were evaluated. The impact of surgical procedures, radiotherapy characteristics and addition of chemotherapy on late laryngeal toxicity was studied. Results. The median follow-up was 38 months. Overall survival and disease-free survival at 5 years were 73% and 66%, respectively. Three (9%) patients experienced local recurrence (after 22, 25 and 40 months, respectively) and were treated with total laryngectomy. The larynx preservation rate was 93%. Severe treatment-related late laryngeal toxicity (grade 3 and 4 laryngeal edema, laryngeal stenosis, presence of tracheotomy at last follow-up because of treatment-related toxicity, and the need for enteral nutrition) was experienced by 34% of patients. The functional larynx preservation rate was 81%. The statistically significant risk factors for severe late toxicity were: female gender, extension of the surgical procedure, removal of one arytenoid and association with concomitant chemotherapy. Conclusions. We confirmed literature data on the feasibility and efficacy of a surgical organ preservation strategy. However, the high incidence of severe late toxicity requires further studies to improve patient selection and to reduce side effects. Copyright - Il Pensiero Scientifico Editore.

KW - Concomitant chemoradiotherapy

KW - Conservative surgery

KW - Functional organ preservation

KW - Laryngeal cancer

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U2 - 10.1700/1390.15454

DO - 10.1700/1390.15454

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VL - 99

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EP - 675

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SN - 0300-8916

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