New Therapeutic Strategies in the Treatment of Stomal Recurrence After Total Laryngectomy: Role of Immunotherapy

Abstract

Objective The aim of this study was to investigate the incidence of stoma recurrence and the therapeutic strategy outcomes in relation to survival that have been adopted over the past few decades using a monoclonal antibody, specifically nivolumab. Methods This study included a total of 487 patients diagnosed with laryngeal carcinoma undergoing either a laryngectomy or salvage surgery after conservative interventions at the ENT Unit of Federico II University in Naples, Italy, between 2011 and 2021. Following a minimum 2.5-year follow-up and a maximum 21-year follow-up, the results revealed that only 38 patients suffered a stomal recurrence. Results Despite various adopted treatment strategies, the literature reports lower patient survival rates. Following a total laryngectomy, stomal recurrence represents a therapeutic management challenge due to a poor prognosis for nearly every treated case. According to the literature, in fact, despite a low incidence (ie, 0.8–31.3%), the overall mortality rate increases from 77% to 100% after three years. Nevertheless, introducing immunotherapy into cancer treatment has resulted in an observable revolution in the treatment of different types of cancers over the years. Conclusion In light of recorded data on survival following the use of the nivolumab, the case presented in this study allows a new perspective of successfully treating recurrences of squamous carcinoma of the head and neck.

Subjective Perception and Psychoacoustic Aspects of the Laryngectomee Voice: The Impact on Quality of Life

“…Vocal impairment subsequent to total laryngectomy seriously affects the patient’s communicative ability, leading to social and psychological disabilities that remarkably influence the patient’s health and quality of life [ 36 , 37 , 38 ]. This is widely reported in the literature [ 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ] on the improvement in vocal and life quality in patients rehabilitated with tracheoesophageal prostheses. Our results confirmed these data, since TES patients obtained low values on the VAS scale.…”

Sport in the Laryngectomized Patient: A Literature Review and Single Case Presentation

“…Additionally, this surgery brings about aesthetic and psychological consequences, and patient perception of physical health is significantly damaged. The permanent division between the airway and the digestive tract, with the presence of the permanent tracheostomy, determines a series of problems for patients such as: loss of voice, difficulty in swallowing, greater risk of respiratory tract infection, loss of smell and reduction of taste, the ability to perform a Valsalva maneuver, change in the perception of oneself and alteration of social life [ 8 , 9 , 10 ].…”