Does vocal cord fixation preclude nonsurgical management of laryngeal cancer?

Solares, C. Arturo; Wood, Benjamin G.; Rodriguez, Cristina P.; Lorenz, Robert R.; Scharpf, Joseph; Saxton, Jerrold P.; Rybicki, Lisa; Strome, Marshall; Esclamado, Ramon M.; Adelstein, David J.

doi:10.1002/lary.20225

Cited by 23 publications

(12 citation statements)

References 10 publications

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“…Baseline dysfunction, laryngeal or hypopharyngeal tumors, and T4 staging have been shown to portend unfavorable functional outcomes after organ preservation. [20][21][22] A majority of patients in this trial (64%) had T1 to T2 disease, few (9%) had laryngeal or hypopharyngeal tumors, and only 2 (4%) had MBS-evidence of baseline aspiration, explaining in part the satisfactory long-term functional outcomes we observed. Local therapy decisions likely also contributed to better than expected long-term functioning after the induction PCC regimen.…”

Section: Discussionmentioning

confidence: 75%

“…Functional outcomes are influenced by a number of patient, clinical, and treatment factors. Baseline dysfunction, laryngeal or hypopharyngeal tumors, and T4 staging have been shown to portend unfavorable functional outcomes after organ preservation . A majority of patients in this trial (64%) had T1 to T2 disease, few (9%) had laryngeal or hypopharyngeal tumors, and only 2 (4%) had MBS‐evidence of baseline aspiration, explaining in part the satisfactory long‐term functional outcomes we observed.…”

Section: Discussionmentioning

confidence: 99%

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Long‐term functional and survival outcomes after induction chemotherapy and risk‐based definitive therapy for locally advanced squamous cell carcinoma of the head and neck

et al. 2013

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Purpose To evaluate long-term outcomes after induction chemotherapy followed by “risk-based” local therapy for squamous cell carcinoma of the head and neck (SCCHN). Methods Forty-seven patients (stage IV, ≥N2b) were enrolled in a Phase II trial. Baseline and 24-months functional measures included modified barium swallow (MBS) studies, oropharyngeal swallow efficiency (OPSE), and the MD Anderson Dysphagia Inventory (MDADI). Functional status was assessed at 5 years. Results Five-year overall survival was 89% (95% CI: 81%-99%). A non-significant 13% average reduction in swallowing efficiency (OPSE) was observed at 24-months relative to baseline (p=0.191). MDADI scores approximated baseline at 24-months. Among 42 long-term survivors (median=5.9 years), 3 (7.1%) had chronic dysphagia. The rate of final gastrostomy-dependence was 4.8% (2/42). Conclusion Sequential chemoradiotherapy achieved favorable outcomes among patients with locally-advanced SCCHN, mainly of oropharyngeal origin. MBS and MDADI scores found modest swallowing deterioration at 2 years, and chronic aspiration was uncommon in long-term survivors.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Long‐term functional and survival outcomes after induction chemotherapy and risk‐based definitive therapy for locally advanced squamous cell carcinoma of the head and neck

et al. 2013

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“…As a result, the patient retained appreciable vocal cord function of speech and deglutition, and his prognosis was good at two years after primary radiotherapy without tumor recurrence. The return of vocal cord function after chemoradiotherapy is a useful prognostic factor, with a five-year overall survival rate in patients with recovered vocal cord function of 100%, compared with a two-year overall survival rate of patients with vocal cord fixation of less than 40% [13]. Our patient recovered vocal cord fixation, with no obvious signs of tumor recurrence more than two years after initial chemoradiotherapy.…”

Section: Discussionmentioning

confidence: 76%

Unusual computed tomography findings of radionecrosis after chemoradiation of stage IV hypopharyngeal cancer: a case report

2011

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IntroductionRadionecrosis (post-radiotherapy laryngeal submucosal inflammation and necrosis) is a complication of (chemo) radiotherapy for hypopharyngeal cancer that is difficult to differentiate from tumor recurrence.Case presentationA 67-year-old Japanese man presented with a condition extremely difficult to diagnose differentially as radionecrosis or tumor recurrence after radiotherapy for hypopharyngeal cancer. Although tumor recurrence was suspected from clinical conditions and computed tomography findings, pathologic analysis revealed no evidence of tumor recurrence, and successful therapy with steroids and antibiotics reduced the mucosal edema.ConclusionOur findings emphasize the wide spectrum of radiographic presentation of radionecrosis after chemoradiation of stage IV hypopharyngeal cancer.

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“…Several recently published reports corroborate the poorer prognosis associated with the posterior spread of glottic carcinoma. TCAS involvement is a negative prognostic factor for intermediate-advanced glottic carcinomas in terms of locoregional control rates after both surgical and nonsurgical treatments 5,7,11,12 .…”

Section: Discussionmentioning

confidence: 99%

The thyro-cricoarytenoid space (TCAS): clinical and prognostic implications in laryngeal cancer

Lucioni

Lionello

Guida

et al. 2020

Acta Otorhinolaryngol Ital

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The recent literature on laryngeal surgical oncology has increasingly focused on the negative prognostic impact of neoplastic involvement of the posterior portion of the inferior paraglottic space, which we refer to as the "thyro-cricoarytenoid space" (TCAS). We retrospectively considered the prognostic significance of TCAS involvement in a cohort of 84 patients treated with open partial horizontal laryngectomy for glottic squamous cell carcinoma. Univariate analysis was conducted on the prognostic value of several clinical and pathological parameters. Cases with TCAS involvement experienced a higher recurrence rate and shorter disease-free survival. Neoplasms involving the TCAS should be considered and treated as extralaryngeal malignancies. Posterior glottic tumours with TCAS invasion have worse prognosis when managed with conservative surgery. Total laryngectomy should be considered in cases of locally-advanced glottic carcinoma with TCAS involvement.

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Does vocal cord fixation preclude nonsurgical management of laryngeal cancer?

Abstract: Nonsurgical therapy in patients with pretreatment vocal cord fixation is feasible. However, persistence of vocal cord fixation after definitive chemoradiotherapy is a poor prognostic sign and early surgical intervention should be considered. Laryngoscope, 2009.

Cited by 23 publications

References 10 publications

Long‐term functional and survival outcomes after induction chemotherapy and risk‐based definitive therapy for locally advanced squamous cell carcinoma of the head and neck

Long‐term functional and survival outcomes after induction chemotherapy and risk‐based definitive therapy for locally advanced squamous cell carcinoma of the head and neck

Unusual computed tomography findings of radionecrosis after chemoradiation of stage IV hypopharyngeal cancer: a case report

The thyro-cricoarytenoid space (TCAS): clinical and prognostic implications in laryngeal cancer

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