Locally advanced laryngeal cancer: Total laryngectomy or primary non-surgical treatment?

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F18%3A10376258" target="_blank" >RIV/00216208:11110/18:10376258 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11120/18:43916671 RIV/00064173:_____/18:N0000059

Result on the web

<a href="https://doi.org/10.3892/ol.2018.8150" target="_blank" >https://doi.org/10.3892/ol.2018.8150</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3892/ol.2018.8150" target="_blank" >10.3892/ol.2018.8150</a>

Result language

angličtina

Original language name

Locally advanced laryngeal cancer: Total laryngectomy or primary non-surgical treatment?

Original language description

Between January 1997 and December 2013, the Charles University 3rd Medical School and Royal Vinohrady Teaching Hospital Ear, Nose and Throat oncology team treated 185 patients with advanced laryngeal cancer, which, from a surgical perspective, required a total laryngectomy. Overall, similar to 70% of these patients (n=129) underwent conventional treatment (i.e., total laryngectomy with post-operative radiotherapy), and similar to 30% (n=56) were treated with larynx preservation protocols (including primary radiotherapy, neoadjuvant chemotherapy followed by radiotherapy or chemoradiotherapy, or primary chemoradiotherapy). Patients treated with laryngeal preservation protocols had a 5-year survival probability of 48%, whereas those treated with total laryngectomy and post-operative radiotherapy had a 5-year survival probability of 63%. This difference was not statistically significant. However, patients who underwent primary surgical treatment survived for a significantly longer period (P&lt;0.010). The sex of the patient did not have a statistically significant impact on patient survival probability. More extensive local disease and more advanced disease stages conferred a lower survival probability, but were not statistically significant; however, a lower survival probability in patients &gt;70 years was identified to be statistically significant (P&lt;0.010). Local disease recurrence and recurrent cervical nodal metastases had a statistically significant impact on the 5-year survival probability (P&lt;0.001). A step wise Cox regression analysis was used to compare the parameters of sex, patient age, tumor extent, disease stage, choice of primary surgery, local recurrence and cervical nodal recurrence. In the first step, local recurrence was selected as the parameter having the greatest effect on survival (P&lt; 0.001); patient age &gt;70 years (P&lt;0.001) was selected in the second step; cervical nodal recurrence (P&lt;0.001) in the third step; and disease stage (P&lt;0.010) in the fourth step. Other parameters did not significantly affect survival. The results of the present study confirmed that primary non-surgical treatment is an alternative approach to total laryngectomy, and that an informed patient should determine the treatment approach. The decreased overall survival observed in more extensive tumors suggests that surgical treatment may be a better selection in these cases. Due to increased overall survival, primary non-surgical treatment may be recommended for younger patients. If the patient chooses primary non-surgical treatment, concomitant chemoradiotherapy is recommended. If the patient cannot tolerate cytostatic chemotherapy, radiotherapy alone is recommended.

Czech name

—

Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30206 - Otorhinolaryngology

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Oncology Letters

ISSN

1792-1074

e-ISSN

—

Volume of the periodical

15

Issue of the periodical within the volume

5

Country of publishing house

GR - GREECE

Number of pages

8

Pages from-to

6701-6708

UT code for WoS article

000431825900082

EID of the result in the Scopus database

2-s2.0-85044658377