Sudhir Vasudevan Nair1, Manish Mair2, Noopur Sawarkar2, Swagnik Chakrabarti2, Burhanuddin Qayyumi2, Deepa Nair2, Pankaj Chaturvedi2, Tejpal Gupta3, Jai Prakash Agrawal3. 1. Head and Neck Surgical Oncology, Homi Bhabha National Institute, Tata Memorial Center, Room No. 1206, Homi Bhabha Block, Dr. E. Borges Road, Parel, Mumbai, 400012, India. sudhirvr@gmail.com. 2. Head and Neck Surgical Oncology, Homi Bhabha National Institute, Tata Memorial Center, Room No. 1206, Homi Bhabha Block, Dr. E. Borges Road, Parel, Mumbai, 400012, India. 3. Radiation Oncology, Homi Bhabha National Institute, Tata Memorial Center, Mumbai, India.
Abstract
OBJECTIVE: The main objective is to compare the oncologic outcomes of patients with T3 laryngeal cancers who underwent total laryngectomy or organ preservation protocol (OPP) as the initial plan of management. MATERIALS AND METHODS: This is a retrospective study on 120 patients treated for T3 laryngeal and hypopharyngeal cancers. Patients with functional larynx underwent OPP and dysfunctional larynx underwent upfront laryngectomy. Median follow-up of the patients was 4.6 years. RESULTS: There was a significant difference in 3 year disease-free survival (DFS) between upfront laryngectomy and OPP (73.2 vs. 55.7%; P = 0.028) group but not in 3 year overall survival (73.2 vs. 68.7%, P = 0.8). The rate laryngeal preservation was 65% in CCRT and 44% in only radiotherapy group. At 3 years, the laryngectomy-free survival was 57.2% and the laryngo-esophageal dysfunction-free survival (LEDS) was 53.0%. CONCLUSION: T3 laryngeal cancers treated with upfront laryngectomy have an improved DFS when compared to those treated with non-surgical modalities. Primary surgery should be offered as an option for selected patients especially when CCRT is not feasible.
OBJECTIVE: The main objective is to compare the oncologic outcomes of patients with T3 laryngeal cancers who underwent total laryngectomy or organ preservation protocol (OPP) as the initial plan of management. MATERIALS AND METHODS: This is a retrospective study on 120 patients treated for T3 laryngeal and hypopharyngeal cancers. Patients with functional larynx underwent OPP and dysfunctional larynx underwent upfront laryngectomy. Median follow-up of the patients was 4.6 years. RESULTS: There was a significant difference in 3 year disease-free survival (DFS) between upfront laryngectomy and OPP (73.2 vs. 55.7%; P = 0.028) group but not in 3 year overall survival (73.2 vs. 68.7%, P = 0.8). The rate laryngeal preservation was 65% in CCRT and 44% in only radiotherapy group. At 3 years, the laryngectomy-free survival was 57.2% and the laryngo-esophageal dysfunction-free survival (LEDS) was 53.0%. CONCLUSION: T3 laryngeal cancers treated with upfront laryngectomy have an improved DFS when compared to those treated with non-surgical modalities. Primary surgery should be offered as an option for selected patients especially when CCRT is not feasible.
Entities:
Keywords:
Larynx; Organ preservation protocol; Surgery; Survival; T3
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