Partial Laryngectomy for pT4a Laryngeal Cancer: Outcomes and Limits in Selected Cases

A large multi-institutional case series of laryngeal cancer (LC) T4a was carried out, including 134 cases treated with open partial horizontal laryngectomies (OPHL) +/- post-operative radiation therapy (PORT). The goal was to understand better whether OPHL can be included among the viable options in...

Full description

Saved in:
Bibliographic Details
Published in:Cancers 2023-05, Vol.15 (10), p.2861
Main Authors: Succo, Giovanni, Bertolin, Andy, Santos, Izabela Costa, Tascone, Martina, Lionello, Marco, Fantini, Marco, de Freitas, Andressa Silva, Bertotto, Ilaria, Sprio, Andrea Elio, Sanguineti, Giuseppe, Dias, Fernando Luiz, Rizzotto, Giuseppe, Crosetti, Erika
Format: Article
Language:English
Subjects:
Cancer
Care and treatment
Cartilage
Chemotherapy
Complications
Consent
Endoscopy
Epiglottis
Health aspects
Hospitals
Laryngeal cancer
Larynx
Magnetic resonance imaging
Medical prognosis
Neck
Patients
Physiology
Radiation therapy
Radiotherapy
Standardization
Surgery
Survival
Thyroid gland
Tracheostomy
Tumors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A large multi-institutional case series of laryngeal cancer (LC) T4a was carried out, including 134 cases treated with open partial horizontal laryngectomies (OPHL) +/- post-operative radiation therapy (PORT). The goal was to understand better whether OPHL can be included among the viable options in selected pT4a LC patients who refuse a standard approach, represented by total laryngectomy (TL) + PORT. All 134 patients underwent OPHL type I (supraglottic), II (supracricoid), or III (supratracheal), according to the European Laryngological Society Classification. Comparing clinical and pathological stages showed pT up-staging in 105 cases (78.4%) and pN up-staging in 19 patients (11.4%). Five-year data on overall survival, disease-specific survival, disease-free survival, freedom from laryngectomy, and laryngo-esophageal dysfunction-free survival (rate of patients surviving without a local recurrence or requiring total laryngectomy and without a feeding tube or a tracheostomy) were, respectively, 82.1%, 89.8%, 75.7%, 89.7%, and 78.3%. Overall, complications were observed in 22 cases (16.4%). Sequelae were observed in 28 patients (20.9%). No patients died during the postoperative period. This large series highlights the good onco-functional results of low-volume pT4a laryngeal tumors, with minimal or absent cartilage destruction, treated with OPHLs. The level of standardization of the indication for OPHL should allow consideration of OPHL as a valid therapeutic option in cases where the patient refuses total laryngectomy or non-surgical protocols with concomitant chemo-radiotherapy.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers15102861