BACKGROUND: Despite the demonstrated survival equivalence between chemoradiation and ablative surgery as primary treatment for advanced laryngeal and hypopharyngeal cancers, a subset of patients who undergo organ-preservation therapy have persistent tracheostomy requirement after completion of treatment. METHODS: Patients who received primary chemoradiation for advanced laryngeal or hypopharyngeal cancer in a 3-year interval were identified. Rate of persistent posttreatment tracheostomy requirement was evaluated. The 12-month overall mortality rate was compared between patients who did and did not receive a tracheostomy before treatment. RESULTS: In 60 patients identified for this study, T3/T4 status and hemilarynx fixation at the time of presentation were associated with persistent tracheostomy requirement 6 and 12 months posttreatment (p = .022; p < .001; and p = .032; p = .0495, respectively). Twelve-month mortality was higher in T3/T4 patients who received pretreatment tracheostomy (p = .034). CONCLUSION: Patients with advanced laryngeal or hypopharyngeal cancer who require tracheostomy before treatment have low rates of decannulation and higher short-term mortality than those who do not require tracheostomy before organ-preservation therapy.
BACKGROUND: Despite the demonstrated survival equivalence between chemoradiation and ablative surgery as primary treatment for advanced laryngeal and hypopharyngeal cancers, a subset of patients who undergo organ-preservation therapy have persistent tracheostomy requirement after completion of treatment. METHODS:Patients who received primary chemoradiation for advanced laryngeal or hypopharyngeal cancer in a 3-year interval were identified. Rate of persistent posttreatment tracheostomy requirement was evaluated. The 12-month overall mortality rate was compared between patients who did and did not receive a tracheostomy before treatment. RESULTS: In 60 patients identified for this study, T3/T4 status and hemilarynx fixation at the time of presentation were associated with persistent tracheostomy requirement 6 and 12 months posttreatment (p = .022; p < .001; and p = .032; p = .0495, respectively). Twelve-month mortality was higher in T3/T4 patients who received pretreatment tracheostomy (p = .034). CONCLUSION:Patients with advanced laryngeal or hypopharyngeal cancer who require tracheostomy before treatment have low rates of decannulation and higher short-term mortality than those who do not require tracheostomy before organ-preservation therapy.
Authors: Abrahim Al-Mamgani; Arash Navran; Iris Walraven; Willen Hans Schreuder; Margot E T Tesselaar; Willem Martin C Klop Journal: Eur Arch Otorhinolaryngol Date: 2018-12-18 Impact factor: 2.503
Authors: Newton J Hurst; Lucio M Pereira; Michael M Dominello; Gregory Dyson; Pamela Laszewski; Natasha Robinette; Ho-Sheng Lin; George Yoo; Ammar Sukari; Harold Kim Journal: Head Neck Date: 2016-04-30 Impact factor: 3.147
Authors: Carlos Miguel Chiesa Estomba; Frank Alberto Betances Reinoso; Virginia Martinez Villasmil; Maria Jesus González Cortés; Carmelo Santidrian Hidalgo Journal: Int Arch Otorhinolaryngol Date: 2017-04-03