Laryngectomy survey

Introduction:

There is an inherent focus on larynx-preserving-therapy in pharyngeal and laryngeal cancer. In literature, classical laryng(opharnyg)ectomy (LPE) becomes less important. However, recent data demonstrates a stable LPE rate over the last decades.

Methods:

Five centers included 783 patients (2004 – 2014) who underwent LPE. Data were compared with oncological parameters of 2,307 patients who suffered from primary hypopharyngeal and laryngeal cancer and underwent chemo-/radiation (C/RT), larynx-preserving-surgery (LpreS), or LPE.

Results:

There was a stable LPE rate in the analyzed period. LPE was done as primary therapy in 80% of patients and in 20% due to recurrence. Analysis of the overall survival (OS) in LpreS vs. C/RT demonstrated comparable OS in T1/2N0 supraglottic, glottic, and hypopharyngeal cancer (p = 0.63; p = 0.26; p = 0.61). Nodal-positive or ≥T3/4N0 supraglottic/hypopharyngeal cancer showed significantly better OS after LpreS/LPE than C/RT (p < 0.0001 – 0.04). LPE was associated with significantly better OS in ≥T3N0 glottic cancer when compared with C/RT (p < 0.0001 – 0.001). LPE due to recurrent disease did not result in reduced OS compared to primary LPE exclusively in glottic cancer.

Conclusions:

LpreS and C/RT can be applied in T1/2N0 cancer. We have to recognize that tumor recurrence after larynx-preserving therapy will reduce OS in hypopharyngeal and supraglottic cancer. Surgical approaches should be preferred in nodal-positive and ≥T3 cancer.

Publication History

Publication Date:
23 April 2019 (online)