Current status of larynx organ preservation for laryngeal cancer in China

Over the past several decades, larynx organ preservation in the management of laryngeal cancer has attracted much attention from head and neck oncologists worldwide. It is a prevailing trend in China that for early staged (mainly T1, partly T2) glottic and supraglottic laryngeal cancers, surgical resection including transoral laser surgery is mostly used even though radiotherapy can achieve equal effects in survival and larynx organ preservation. For T2, T3 and limited T4 cancers, various open organ preservation surgeries have been introduced, and all reveal stable oncologic and functional outcomes. The major operative modalities include vertical laryngectomies, horizontal laryngectomies, and supracricoid laryngectomies, all of which are indicated in different primary cancer situations. Larynx organ preservation surgery should be carried out in some selective recurrent cases after radiotherapy, laser surgery and even partial laryngectomies. Supracricoid partial laryngectomies are the very useful for salvage surgery. For glottis cancers involving the anterior commissure and bilateral vocal cords, we designed a novel surgical procedure called “infraventricular partial laryngectomy”, an open surgical approach capable of preserving parts of laryngeal frame and reconstructing a neolarynx, ensuring high decannulation rates and good voice quality after tumor resection. Preoperative radiotherapy or induction chemotherapy has been used in some T3 and T4 cases for reducing the tumor volume and improving the chance of laryngeal preservation. Considering its toxic and side effects, concomitant chemotherapy and radiotherapy (CCRT) is only indicated in the T3 and T4 cases with great desire in preserving larynx function whenever laryngeal preservation surgeries are contraindicated.

Publikationsverlauf

Publikationsdatum:
18. April 2018 (online)