Yu-Qin He1, Xi-Wei Zhang1, Yi-Ming Zhu1, Xiao-Guang Ni2, Ze-Hao Huang1, Chang-Ming An1, Jun-Lin Yi3, Shao-Yan Liu1. 1. Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. 2. Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China. 3. Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Abstract
INTRODUCTION: We aimed to analyze the relationship between the changed status of vocal cord mobility and survival outcomes. METHODS: Seventy-eight patients with dysfunctional vocal cords and hypopharyngeal carcinomas accepted non-surgical treatment as the initial therapy between May 2009 and December 2016. Vocal cord mobility was assessed before and after the initial non-surgical treatment. The cord mobility status was classified as normal, impaired, and fixed. Patients with improved mobility (IM) (n =56) were retrospectively analyzed for disease-free survival (DFS), recurrence-free survival (RFS), and overall survival (OS) and compared with 22 patients with non-improved mobility (non-IM). RESULTS: Fifty-six (71.8%) patients had improved cord mobility after the initial non-surgical treatment. The non-improved cord mobility was significantly associated with shortened DFS (P=0.005), RFS (P=0.002), and OS (P<0.001). If non-improved cord mobility was regarded as an indicator for local-regional recurrence within 1 year, the sensitivity and the specificity were 60.9%, 87.5% respectively. The multivariate analysis showed that improved cord mobility (P=0.006) and salvage surgery (P=0.015) were both independent protective factors for OS. CONCLUSION: Changes in cord mobility are a key marker for predicting prognosis. Non-improved cord mobility may indicate a high possibility of a residual tumor, therefore, patients whose cord mobility remains dysfunctional or worsens after non-surgical treatment might need an aggressive salvage strategy.
INTRODUCTION: We aimed to analyze the relationship between the changed status of vocal cord mobility and survival outcomes. METHODS: Seventy-eight patients with dysfunctional vocal cords and hypopharyngeal carcinomas accepted non-surgical treatment as the initial therapy between May 2009 and December 2016. Vocal cord mobility was assessed before and after the initial non-surgical treatment. The cord mobility status was classified as normal, impaired, and fixed. Patients with improved mobility (IM) (n =56) were retrospectively analyzed for disease-free survival (DFS), recurrence-free survival (RFS), and overall survival (OS) and compared with 22 patients with non-improved mobility (non-IM). RESULTS: Fifty-six (71.8%) patients had improved cord mobility after the initial non-surgical treatment. The non-improved cord mobility was significantly associated with shortened DFS (P=0.005), RFS (P=0.002), and OS (P<0.001). If non-improved cord mobility was regarded as an indicator for local-regional recurrence within 1 year, the sensitivity and the specificity were 60.9%, 87.5% respectively. The multivariate analysis showed that improved cord mobility (P=0.006) and salvage surgery (P=0.015) were both independent protective factors for OS. CONCLUSION: Changes in cord mobility are a key marker for predicting prognosis. Non-improved cord mobility may indicate a high possibility of a residual tumor, therefore, patients whose cord mobility remains dysfunctional or worsens after non-surgical treatment might need an aggressive salvage strategy.
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: Walter T Lee; David S Yoo; Liana Puscas; David Witsell; Seth M Cohen; Samuel R Fisher; Richard Scher; Gloria Broadwater; Neal Ready; David R Brizel; Ramon M Esclamado Journal: Head Neck Date: 2011-08-17 Impact factor: 3.147
Authors: Serena A Byrd; Mary J Xu; Lauren M Cass; Daniel J Wehrmann; Matthew Naunheim; Kara Christopher; John J Dombrowski; Ronald J Walker; Lori Wirth; John Clark; Paul Busse; Annie Chan; Daniel G Deschler; Kevin Emerick; Derrick T Lin; Mark A Varvares Journal: Oral Oncol Date: 2018-02-20 Impact factor: 5.337
Authors: Allen S Ho; Sungjin Kim; Mourad Tighiouart; Cynthia Gudino; Alain Mita; Kevin S Scher; Anna Laury; Ravi Prasad; Stephen L Shiao; Nabilah Ali; Chrysanta Patio; Jon Mallen-St Clair; Jennifer E Van Eyk; Zachary S Zumsteg Journal: JAMA Oncol Date: 2018-07-01 Impact factor: 31.777