Prognostic Accuracy of Computed Tomography Findings for Patients With Laryngeal Cancer Undergoing Laryngectomy

Beitler, Jonathan J.; Müller, Susan; Grist, William; Corey, Amanda S.; Klein, Adam M.; Johns, Michael M.; Perkins, Charles; Davis, Lawrence W.; Udayasanker, Unni; Landry, Jerome C.; Shin, Dong M.; Hudgins, Patricia A.

doi:10.1200/jco.2009.24.7544

Cited by 91 publications

(56 citation statements)

References 12 publications

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“…Another potential limitation is the use of clinical staging rather than pathologic staging; that is, the accuracy of CT-based staging for advanced laryngeal cancers recently has been brought into question. 13 In conclusion, CRT should remain the standard treatment for laryngeal preservation compared with radiotherapy alone for locoregionally advanced squamous cell carcinomas of the larynx and hypopharynx using LEDFS as an endpoint. Pretreatment dysphagia may be a useful exclusion criterion for laryngeal conservation; however, we have not tested the efficacy of swallowing therapy.…”

Section: Resultsmentioning

confidence: 99%

Examination of laryngoesophageal dysfunction‐free survival as an endpoint in nonsurgical treatment of squamous cell carcinomas of the larynx and hypopharynx

Caudell

Carroll

Spencer

et al. 2011

Cancer

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BACKGROUND:A recently published consensus guideline suggested a new endpoint for clinical trials involving cancer of the larynx and hypopharynx: laryngoesophageal dysfunction-free survival (LEDFS). The authors of this report examined LEDFS in the context of definitive radiotherapy alone (RT) or with concurrent chemoradiotherapy (CRT). METHODS: Patients with a stage III to IVB squamous cell carcinomas of the larynx or hypopharynx who received definitive radiotherapy were included. Consensus guidelines also suggested analysis of the following: tumor classification, lymph node status, pretreatment tracheotomy, pretreatment swallowing dysfunction, and subsite. LEDFS was assessed using Kaplan-Meier survival analyses. RESULTS: Eighty-five patients (73.9%) received CRT, and 30 patients (26.1%) received RT. For the entire cohort, the 3-year LEDFS rate was 28.9%. CRT was associated with an improved LEDFS at 3 years (32.2% vs 20%; P ¼ .02). Pretreatment dysphagia (P ¼ .06) and N2 or N3 lymph node status (P ¼ .09) demonstrated a trend toward poorer LEDFS, but patients who had T4 tumors had an LEDFS similar to that of patients who had T2 and T3 tumors. CONCLUSIONS: LEDFS was superior in patients who received CRT compared with patients who received RT alone. T4 status was not associated with a worse LEDFS. Cancer 2011;117:4447-51.

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Section: Resultsmentioning

confidence: 99%

Examination of laryngoesophageal dysfunction‐free survival as an endpoint in nonsurgical treatment of squamous cell carcinomas of the larynx and hypopharynx

Caudell

Carroll

Spencer

et al. 2011

Cancer

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“…When done well, this provides reliable findings from which conclusions can be drawn and decisions made. 179 180 The key characteristics of a systematic review are: (a) a clearly stated set of objectives with an explicit, reproducible methodology; (b) a systematic search that attempts to identify all studies that would meet the eligibility criteria; (c) an assessment of the validity of the findings of the included studies (such as assessment of risk of bias and confidence in cumulative estimates); and (d) systematic presentation, and synthesis, of the characteristics and findings of the included studies. A meta-analysis is a mathematical synthesis of the results of two or more primary studies that addressed the same hypothesis in the same way.…”

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confidence: 99%

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Mannelli

Cecconi

Gallo

2016

Critical Reviews in Oncology/Hematology

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Abstract.Background: Multi-step cancerogenesis guides laryngeal cancer onset and it includes a wide variety of pre-cancerous lesions that are macroscopically challenging to identify and distinguish from initial cancerous foci. Since the treatment of laryngeal cancer and its precursor lesions has a great impact on important laryngeal basic functions, early detection and preoperative assessment are important for a curative and function-preserving therapy. Nowadays, despite the high number of more advanced diagnostic techniques and methods, unfortunately, it is not uncommon for different clinicians to use different nomenclature or to identify different stage for the same laryngeal lesion. From these observations, it is obvious that an instrument offering the possibility to detect precancerous lesions, early cancerous lesions, and satellite foci or second primaries would be the key to improving management and outcome in laryngeal patients. Object. Different modalities of diagnostic techniques of laryngeal lesions exist. Rather than difference between benign and obvious malignant diseases, more difficult is to detect the presence of precancerous epithelial alterations. Not all tests achieve the same diagnostic accuracy, hence this meta-analysis of literature aimed to synthesize the validity of each single diagnostic technique in identifying and staging laryngeal disease. Methods: A systematic review of literature was led searching for articles mentioning the following terms including their various combinations to maximize the yield: larynx, laryngeal precancerous lesions, laryngeal cancer, white light (WL) endoscopy, stroboscopy, contact endoscopy (CE), autofluorescence (AF), ultrasound (US), narrow band imaging (NBI), computed axial tomography (CAT), magnetic resonance imaging (MRI), positron emission tomography (PET), CAT/PET. Then, a quantitative analysis was carried on for paper published after 2005 onward, reporting a minumun series of 10 patients each study, declaring sensitivity and specificity of each diagnostic system. Results: The search identified 7215 publications, of which 3616 published after 2005, with a final results of a total of 214 articles stratified and included by our selection criteria. 42 out of 214 articles were selected for quantitative synthesis. 25 out of 41 studies had a quality score of ≥ 6 (good), 16 presented a score between 4 and 5 (fair). While objections can be raised about the pooling of different diagnostic procedures under the same group and the high level of heterogeneity in the meta-analyses, the inclusion of over 4400 laryngeal lesions makes the results fairly robust. Conclusions: A comprehensive overview of the most recent advances in laryngeal imaging technology combined with all of the information needed to interpret findings and successfully manage patients with voice disorders can be found herein. With these data, clinicians can riskstratify patients and select proper examination modalities in order to provide appropriate care. Moreover, study limitations, together with p...

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“…A comparison among original indications to SCPL [3][4][5][6][7][8] and recent literature results [9,15,16], supports a clear development and more extended use of this procedure [33][34][35][36][37]. Progression in CAT scan and MRI [10,11], as well new diagnostic endoscopic laryngeal procedures [12][13][14], allow a millimetric evaluation of tumor extension with a more accurate treatment planning, rendering the surgeon more confident in SCPL option. Accordingly, here we reported a larger use of SCPL in older patients (p = 0.02), T3 staged patients (p = 0.02) and for CHEP than for CHP (p = 0.001).…”

Section: Discussionmentioning

confidence: 75%

“…All of these surgeons proposed supracricoid partial laryngectomy as valid surgical alternative to total laryngectomy in elective T1 and T2 laryngeal cancer patients, describing it as a technique able to ensure recovery from the disease and laryngeal function preservation together. So far, surgical indications have been changed and extended to more advanced staged cancers [1,4,9] because of the improvement of diagnostic technologies such as CAT scan and MRI [10,11], a more precise stage of the disease by endoscopic fiberoptic together with fluorescence or narrow banding imaging (NBI) exams [12][13][14], as well as because of the advent of new surgical devices [15] which allowed the improvement of the intraoperative management of the operation and the surgical technique as well. All of these changes, together with the help of frozen section analysis in the intraoperative control of resection margins [16,17], have determined a radical turn in the management of these laryngeal cancer patients during the last 40 years, furthermore, with the new concept that recurrent irradiated cancer has to be treated as a primitive one, with no worsening in staging status and surgical indication, with no absolute contraindication for SCPL [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Subtotal supracricoid laryngectomy: changing in indications, surgical techniques and use of new surgical devices

Mannelli

Meccariello

Deganello

et al. 2014

American Journal of Otolaryngology

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Purpose: The aim of this study is to evaluate the evolution of supracricoid partial laryngectomy (SCPL) in indications, surgical techniques and outcomes through last decades. Oncological outcomes did not report any significant differences. Group B showed a higher incidence of post-operative arytenoid edema (p = 0.03) associated with a lower rate of pneumonia (p = 0.038). Despite a higher rate of close or positive-margins found in group B no higher incidence of local-recurrence was reported (p = 0.02) compared to group A. Conclusions: We documented changing in indications and surgical technique for SCPL because of the development of modern diagnostic techniques and the introduction of low-thermal injury device allowing a more challenging tumor excision as well as with a shorter swallowing recovery in our series.

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Prognostic Accuracy of Computed Tomography Findings for Patients With Laryngeal Cancer Undergoing Laryngectomy

Cited by 91 publications

References 12 publications

Examination of laryngoesophageal dysfunction‐free survival as an endpoint in nonsurgical treatment of squamous cell carcinomas of the larynx and hypopharynx

Examination of laryngoesophageal dysfunction‐free survival as an endpoint in nonsurgical treatment of squamous cell carcinomas of the larynx and hypopharynx

Laryngeal preneoplastic lesions and cancer: challenging diagnosis. Qualitative literature review and meta-analysis.

Subtotal supracricoid laryngectomy: changing in indications, surgical techniques and use of new surgical devices

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