Isabel Vilaseca1,2,3,4, Anna Nogués-Sabaté1,2, Francesc Xavier Avilés-Jurado1,2,3,4, Joan Berenguer3,4,5, Juan José Grau2,3,4,6, Eugenia Verger4,7, Alfons Nadal4,8, Africa Muxí4,9, Manuel Bernal-Sprekelsen1,10, José Luis Blanch1. 1. Otolaryngology Department, Hospital Clínic, Barcelona, Spain. 2. Head Neck Clínic, Agència de Gestió d'Ajuts Universitaris i de Recerca, Barcelona, Catalunya, Spain. 3. Institutd'Investigacions Biomèdiques Agusti Pi Sunyer (IDIBAPS), Barcelona, Spain. 4. Faculty of Medicine, University of Barcelona, Barcelona, Spain. 5. Radiology Department, Hospital Clínic, Barcelona, Spain. 6. Oncology Department, Hospital Clínic, Barcelona, Spain. 7. Radiotherapy Department, Hospital Clínic, Barcelona, Spain. 8. Pathology Department, Hospital Clínic, Barcelona, Spain. 9. Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain. 10. Faculty of Medicine, University of Valencia, Valencia, Spain.
Abstract
BACKGROUND: Indications of transoral laser microsurgery (TLM) are conditioned by the risk of local relapse. OBJECTIVE: To evaluate prognostic factors of local relapse and local control with TLM (LC-TLM). METHODS: Local relapse and LC-TLM were evaluated in 1119 patients. Logistic regression and CHAID decision tree analysis were performed. RESULTS: Local relapse correlated to previous radiotherapy failure (8.45, CI 95%: 2.64-27.03; P < .001), paraglottic involvement (2.42, CI: 1.41-4.15; P = .001), anterior commissure involvement (2.12, CI: 1.43-3.14; P < .001), grade of differentiation (1.74, CI: 1.18-2.57; P = .005), and alcohol consumption (1.4, CI: 0.99-1.98; P = .057). Local relapse tended to inversely correlate with experience (0.73, CI: 0.51-1.03; P = .078). The most important factors for local relapse were previous radiotherapy failure and anterior commissure involvement. LC-TLM inversely correlated with previous radiotherapy failure (0.09, CI: 0.03-0.28; P < .001), paraglottic involvement (0.25, CI: 0.14-0.43; P < .001), anterior commissure involvement (0.49, CI: 0.32-0.77; P = .007), margins (0.56, CI: 0.30-1.04; P = .068), and differentiation (0.68, CI: 0.44-1.05; P = .087). LC-TLM correlated with experience (1.71, CI: 1.13-2.55; P = .010). The most important factors for LC-TLM were previous radiotherapy failure and paraglottic involvement. CONCLUSION: Previous radiotherapy failure is the most important factor for local relapse and LC-TLM. In primary treatments, anterior commissure involvement and paraglottic involvement are the most important factors for local relapse and LC-TLM, respectively.
BACKGROUND: Indications of transoral laser microsurgery (TLM) are conditioned by the risk of local relapse. OBJECTIVE: To evaluate prognostic factors of local relapse and local control with TLM (LC-TLM). METHODS: Local relapse and LC-TLM were evaluated in 1119 patients. Logistic regression and CHAID decision tree analysis were performed. RESULTS: Local relapse correlated to previous radiotherapy failure (8.45, CI 95%: 2.64-27.03; P < .001), paraglottic involvement (2.42, CI: 1.41-4.15; P = .001), anterior commissure involvement (2.12, CI: 1.43-3.14; P < .001), grade of differentiation (1.74, CI: 1.18-2.57; P = .005), and alcohol consumption (1.4, CI: 0.99-1.98; P = .057). Local relapse tended to inversely correlate with experience (0.73, CI: 0.51-1.03; P = .078). The most important factors for local relapse were previous radiotherapy failure and anterior commissure involvement. LC-TLM inversely correlated with previous radiotherapy failure (0.09, CI: 0.03-0.28; P < .001), paraglottic involvement (0.25, CI: 0.14-0.43; P < .001), anterior commissure involvement (0.49, CI: 0.32-0.77; P = .007), margins (0.56, CI: 0.30-1.04; P = .068), and differentiation (0.68, CI: 0.44-1.05; P = .087). LC-TLM correlated with experience (1.71, CI: 1.13-2.55; P = .010). The most important factors for LC-TLM were previous radiotherapy failure and paraglottic involvement. CONCLUSION: Previous radiotherapy failure is the most important factor for local relapse and LC-TLM. In primary treatments, anterior commissure involvement and paraglottic involvement are the most important factors for local relapse and LC-TLM, respectively.
Authors: Ohad Ronen; K Thomas Robbins; Remco de Bree; Orlando Guntinas-Lichius; Dana M Hartl; Akihiro Homma; Avi Khafif; Luiz P Kowalski; Fernando López; Antti A Mäkitie; Wai Tong Ng; Alessandra Rinaldo; Juan P Rodrigo; Alvaro Sanabria; Alfio Ferlito Journal: Eur Arch Otorhinolaryngol Date: 2021-05-12 Impact factor: 2.503
Authors: Cesare Piazza; Alberto Paderno; Elisabeth V Sjogren; Patrick J Bradley; Hans E Eckel; Antti Mäkitie; Nayla Matar; Vinidh Paleri; Giorgio Peretti; Roberto Puxeddu; Miquel Quer; Marc Remacle; Vincent Vander Poorten; Isabel Vilaseca; Ricard Simo Journal: Eur Arch Otorhinolaryngol Date: 2021-07-05 Impact factor: 2.503
Authors: Alberto Paderno; Davide Lancini; Paolo Bosio; Francesca Del Bon; Milena Fior; Giulia Berretti; Marco Alparone; Alberto Deganello; Giorgio Peretti; Cesare Piazza Journal: Laryngoscope Date: 2021-07-07 Impact factor: 2.970