Modified supracricoid laryngectomy: oncological and functional outcomes in the elderly

Abstract

BackgroundSupracricoid laryngectomy is an organ preservation surgical technique for early-stage glottic tumors. Modified supracricoid laryngectomy using sternohyoid muscles for neoglottis reconstruction is a new surgical technique. This report evaluates oncological and functional outcomes of this new technique and its feasibility in elderly patients.MethodsClinical records from 21 consecutive patients affected by glottic cancer and treated by modified SCL between 2004 and 2009 were retrospectively reviewed. Postoperative parameters and quality of voice after modified SCL were retrospectively reviewed. Actuarial overall survival, disease-specific survival rates, and recurrence-free survival rates were assessed. The functional and oncological outcomes of patients over 65 years were compared with those of patients younger than 65 years of age.ResultsThere were no postoperative complications and all of the patients had complete swallowing rehabilitation. Twenty of the 21 patients had decannulation. Two patients received total laryngectomy for locoregional relapse. Overall survival and disease-specific survival rates were 100%. Recurrence-free survival rates were 90.1% and 90% in patients younger and older than 65 years of age, respectively. The larynx preservation index was lower in patients who were older than 65 years of age. The postoperative courses with regard to functional outcome and voice quality in elderly patients were similar to those of patients younger than 65 years of age.ConclusionModified SCL is a new open organ preservation surgical technique that is oncologically safe. The positive functional and oncological outcomes of this surgical procedure allow it to be performed in elderly patients.

Supracricoid laryngectomy and dysphagia: A systematic literature review

“…Allegra et al described no statistically significant difference (X 2 test; P = 0.99) between patients under or over 65 years in functional outcome after SCL. Castro et al did not find a difference in quality‐of‐life outcome in older or younger patients.…”

“…Six studies described the same deglutition outcome independently from radiotherapy; three studies did not. Furthermore, four studies looked into the difference of functional outcome in patients under or over 65 years or 70 years; two studies did not find a statistically significant difference; and two studies did.…”

The Role of BMI1 as a Biomarker of Cancer Stem Cells in Head and Neck Cancer: A Review

“…In the last 30 years, progress in the treatment of head and neck cancer has improved the quality of life of patients through the use of more innovative surgical techniques and multimodal treatments aimed at organ preservation [47,48,49,50]. Markers of CSCs may identify specific subpopulations that are resistant to treatment and require more aggressive therapeutic strategies, based on the early detection of lymph node metastases and/or distance and on the identification of response predictors to conventional treatment.…”

Effectiveness of Therapeutic Selective Neck Dissection in Laryngeal Cancer

“…Most patients affected by laryngeal cancer have locoregionally advanced disease at diagnosis. Conservative surgical techniques have improved the quality of life of patients in the early stage of the disease [2,3,4]; these techniques have been proven to be feasible even in the elderly [5]. However, the survival chances of patients with an advanced stage of the disease have not improved over the last 30 years, and the main causes of treatment failure are the development of cervical lymph nodes and distant metastasis.…”