Partial Laryngectomy for pT4a Laryngeal Cancer: Outcomes and Limits in Selected Cases

被引:10
作者
Succo, Giovanni [1 ,2 ]
Bertolin, Andy [3 ]
Santos, Izabela Costa [4 ]
Tascone, Martina [1 ]
Lionello, Marco [3 ]
Fantini, Marco [1 ]
de Freitas, Andressa Silva [4 ]
Bertotto, Ilaria [5 ]
Sprio, Andrea Elio [6 ]
Sanguineti, Giuseppe [7 ]
Dias, Fernando Luiz [4 ]
Rizzotto, Giuseppe [3 ]
Crosetti, Erika [1 ]
机构
[1] San Giovanni Bosco Hosp, Otorhinolaryngol Unit, I-10154 Turin, Italy
[2] Univ Turin, Oncol Dept, I-10124 Turin, Italy
[3] Vittorio Veneto Hosp, Otorhinolaryngol Unit, AULSS2 Treviso, I-31029 Vittorio Veneto, Italy
[4] Brazilian Natl Canc Inst, BR-20230130 Rio De Janeiro, RJ, Brazil
[5] Candiolo Canc Inst FPO IRCCS, Radiol Serv, I-10060 Turin, Italy
[6] ASOMI Coll Sci, Dept Res, Marsa, Malta
[7] IRCCS Regina Elena Natl Canc Inst, Dept Radiat Oncol, I-00144 Rome, Italy
关键词
laryngeal cancer; partial laryngectomy; OPHL; T4 laryngeal cancer; laryngeal preservation; radiotherapy; PARTIAL HORIZONTAL LARYNGECTOMIES; ONCOLOGIC OUTCOMES; PRESERVATION; CLASSIFICATION; UNIVARIATE; CARCINOMA; SOCIETY; HEAD;
D O I
10.3390/cancers15102861
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
A large multi-institutional case series of laryngeal cancer (LC) T4a was carried out, including 134 cases treated with open partial horizontal laryngectomies (OPHL) +/- post-operative radiation therapy (PORT). The goal was to understand better whether OPHL can be included among the viable options in selected pT4a LC patients who refuse a standard approach, represented by total laryngectomy (TL) + PORT. All 134 patients underwent OPHL type I (supraglottic), II (supracricoid), or III (supratracheal), according to the European Laryngological Society Classification. Comparing clinical and pathological stages showed pT up-staging in 105 cases (78.4%) and pN up-staging in 19 patients (11.4%). Five-year data on overall survival, disease-specific survival, disease-free survival, freedom from laryngectomy, and laryngo-esophageal dysfunction-free survival (rate of patients surviving without a local recurrence or requiring total laryngectomy and without a feeding tube or a tracheostomy) were, respectively, 82.1%, 89.8%, 75.7%, 89.7%, and 78.3%. Overall, complications were observed in 22 cases (16.4%). Sequelae were observed in 28 patients (20.9%). No patients died during the postoperative period. This large series highlights the good onco-functional results of low-volume pT4a laryngeal tumors, with minimal or absent cartilage destruction, treated with OPHLs. The level of standardization of the indication for OPHL should allow consideration of OPHL as a valid therapeutic option in cases where the patient refuses total laryngectomy or non-surgical protocols with concomitant chemo-radiotherapy.
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页数:15
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