Comparison of the therapeutic effects of total laryngectomy and a larynx-preservation approach in patients with T4a laryngeal cancer and thyroid cartilage invasion: A multicenter retrospective review
- Affiliated Author(s)
- 박건욱
- Alternative Author(s)
- Park, Keon Uk
- Journal Title
- Head & Neck
- ISSN
- 1043-3074
- Issued Date
- 2016
- Keyword
- laryngeal cancer; cartilage invasion; larynx preservation; total laryngectomy; prognosis
- Abstract
- Background. In T4a laryngeal cancer with thyroid cartilage
invasion, no optimal frontline treatment has yet been defined in con-
trolled trials.
Methods. We reviewed data from 89 patients with T4a laryngeal
cancer featuring thyroid cartilage invasion who were treated initially
with either total laryngectomy (n 5 53) or a larynx-preservation strategy
(n 5 36).
Results. The median progression-free survival (PFS) of the total laryn-
gectomy group had not been attained at the time of analysis and was
thus significantly longer than that of the larynx-preservation group (8.7
months). The median overall survival (OS) of patients who underwent
total laryngectomy was 87.2 months, significantly longer than that of the
larynx-preservation group (31.3 months). The survival benefit of primary
surgery compared to a larynx-preservation strategy was more striking in
patients of lower N classifications.
Conclusion. Total laryngectomy may be a better therapeutic option to
treat T4a laryngeal cancer featuring thyroid cartilage invasion, especially
in patients exhibiting limited nodal involvement (N0/N1).
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