Yoon Seok Choi1, Sang Gon Park2, Eun-Kee Song3, Sang-Hee Cho4, Moo-Rim Park5, Keon Uk Park6, Ki-Hyeong Lee7, Ik-Chan Song1, Hyo Jin Lee1, Deog-Yeon Jo1, Samyong Kim1, Hwan-Jung Yun1. 1. Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea. 2. Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Republic of Korea. 3. Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea. 4. Department of Internal Medicine, Chonnam National University Medical School, Hwasoon, Republic of Korea. 5. Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea. 6. Department of Internal Medicine, Keimyung University College of Medicine, Daegu, Republic of Korea. 7. Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
Abstract
BACKGROUND: In T4a laryngeal cancer with thyroid cartilage invasion, no optimal frontline treatment has yet been defined in controlled trials. METHODS: We reviewed data from 89 patients with T4a laryngeal cancer featuring thyroid cartilage invasion who were treated initially with either total laryngectomy (n = 53) or a larynx-preservation strategy (n = 36). RESULTS: The median progression-free survival (PFS) of the total laryngectomy group had not been attained at the time of analysis and was thus significantly longer than that of the larynx-preservation group (8.7 months). The median overall survival (OS) of patients who underwent total laryngectomy was 87.2 months, significantly longer than that of the larynx-preservation group (31.3 months). The survival benefit of primary surgery compared to a larynx-preservation strategy was more striking in patients of lower N classifications. CONCLUSION: Total laryngectomy may be a better therapeutic option to treat T4a laryngeal cancer featuring thyroid cartilage invasion, especially in patients exhibiting limited nodal involvement (N0/N1).
BACKGROUND: In T4a laryngeal cancer with thyroid cartilage invasion, no optimal frontline treatment has yet been defined in controlled trials. METHODS: We reviewed data from 89 patients with T4a laryngeal cancer featuring thyroid cartilage invasion who were treated initially with either total laryngectomy (n = 53) or a larynx-preservation strategy (n = 36). RESULTS: The median progression-free survival (PFS) of the total laryngectomy group had not been attained at the time of analysis and was thus significantly longer than that of the larynx-preservation group (8.7 months). The median overall survival (OS) of patients who underwent total laryngectomy was 87.2 months, significantly longer than that of the larynx-preservation group (31.3 months). The survival benefit of primary surgery compared to a larynx-preservation strategy was more striking in patients of lower N classifications. CONCLUSION: Total laryngectomy may be a better therapeutic option to treat T4a laryngeal cancer featuring thyroid cartilage invasion, especially in patients exhibiting limited nodal involvement (N0/N1).
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