Claudia Scherl1, Konstantinos Mantsopoulos2, Sabine Semrau3, Rainer Fietkau3, Markus Kapsreiter2, Michael Koch2, Maximilian Traxdorf2, Philipp Grundtner2, Heinrich Iro2. 1. Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Department of Otorhinolaryngology - Head and Neck Surgery, Waldstrasse 1, 91054 Erlangen, Germany. Electronic address: claudia.scherl@uk-erlangen.de. 2. Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Department of Otorhinolaryngology - Head and Neck Surgery, Waldstrasse 1, 91054 Erlangen, Germany. 3. Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Department of Radiation Oncology, Universitätsstrasse 27, 91054 Erlangen, Germany.
Abstract
OBJECTIVE: To compare efficacy, in terms of disease control/survival in advanced hypopharyngeal and laryngeal lesions, according to treatment strategy (primary surgery, PS or primary chemoradiotherapy, CRT) and invasion pattern (cartilage, CAI or soft tissue involvement, STI). METHODS: Records from 463 patients with T3 and T4a carcinoma with CAI (n=221) or STI (n=242) treated at a university clinic over 18 years were retrospectively reviewed. RESULTS: Disease-specific survival (DSS) for the CAI group was 70.1% (PS) and 38.4% (CRT), and 76.6% and 46% for the STI group, respectively. Overall survival (OS) for STI was 56.4% (PS) and 30.6% (CRT), and for CAI 51.1% (PS) and 28.5% (CRT) respectively. Positive resection margins and regional neck metastases reduced survival. T3 lesions treated non-operatively still had significantly improved survival versus T4a by >20%. CONCLUSION: Surgery remains an indispensable part of treatment in local advanced hypopharyngeal and laryngeal cancer with high survival results. It should be part of a concept that includes adjuvant (C)RT. For T3 lesions, primary CRT is also acceptable and CAI is not a contraindication for primary CRT. Regional disease is a strong prognostic factor. In spite of adjuvant treatment, DSS deteriorates by about 20% in cases with positive resection margins.
OBJECTIVE: To compare efficacy, in terms of disease control/survival in advanced hypopharyngeal and laryngeal lesions, according to treatment strategy (primary surgery, PS or primary chemoradiotherapy, CRT) and invasion pattern (cartilage, CAI or soft tissue involvement, STI). METHODS: Records from 463 patients with T3 and T4a carcinoma with CAI (n=221) or STI (n=242) treated at a university clinic over 18 years were retrospectively reviewed. RESULTS: Disease-specific survival (DSS) for the CAI group was 70.1% (PS) and 38.4% (CRT), and 76.6% and 46% for the STI group, respectively. Overall survival (OS) for STI was 56.4% (PS) and 30.6% (CRT), and for CAI 51.1% (PS) and 28.5% (CRT) respectively. Positive resection margins and regional neck metastases reduced survival. T3 lesions treated non-operatively still had significantly improved survival versus T4a by >20%. CONCLUSION: Surgery remains an indispensable part of treatment in local advanced hypopharyngeal and laryngeal cancer with high survival results. It should be part of a concept that includes adjuvant (C)RT. For T3 lesions, primary CRT is also acceptable and CAI is not a contraindication for primary CRT. Regional disease is a strong prognostic factor. In spite of adjuvant treatment, DSS deteriorates by about 20% in cases with positive resection margins.
Authors: Ewa Osuch-Wójcikiewicz; Daniel Majszyk; Antoni Bruzgielewicz; Tadeusz Grochowiecki; Sławomir Nazarewski; Piotr Chęciński; Kazimierz Niemczyk Journal: Contemp Oncol (Pozn) Date: 2021-04-15
Authors: Maxwell Y Lee; Jonathan Lee; Sarah Stock; Mario Belfiglio; Brian Matia; Shlomo Koyfman; Nikhil P Joshi; Brian B Burkey; Eric Lamarre; Brandon Prendes; Joseph Scharpf; Robert R Lorenz; Neil M Woody; David J Adelstein; Jessica L Geiger; Deborah J Chute; Jamie A Ku Journal: Head Neck Date: 2022-07-08 Impact factor: 3.821
Authors: Matti Sievert; Michael Koch; Konstantinos Mantsopoulos; Maximilian Traxdorf; Sarina K Mueller; Heinrich Iro; Claudia Scherl Journal: Int J Surg Case Rep Date: 2020-10-12