Salvage Surgery After Failure of Nonsurgical Therapy for Carcinoma of the Larynx and Hypopharynx

Stoeckli, Sandro J.; Pawlik, Andreas B.; Lipp, Margareta; Huber, Alexander; Schmid, Stephan

doi:10.1001/archotol.126.12.1473

Cited by 121 publications

(98 citation statements)

References 13 publications

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“…Salvage surgery did not signifi cantly improve survival in our study. We also agree that the treatment strategy should be modifi ed for larger hypopharyngeal cancers, including improvement in the CCRT protocol and further biochemical studies of tumor behavior to reach a better treatment outcome [1,7,8] . …”

Section: Resultsmentioning

confidence: 64%

Analysis of Prognostic Factors of Chemoradiation Therapy for Advanced Hypopharyngeal Cancer – Does Tumor Volume Correlate with Central Necrosis and Tumor Pathology?

Tsou

Mai

Lin

et al. 2006

ORL

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Objectives: Not all patients with hypopharyngeal cancer who undergo concurrent chemoradiation therapy have a good prognosis. We hope to find the significant prognostic factors that could help us in patient selection for concurrent chemoradiation therapy. Study Design: We used a retrospective analysis on several prognostic factors which may affect the treatment outcome and prognosis. Methods: We studied 51 patients with stage III–IV hypopharyngeal cancer who underwent chemoradiation therapy as the first treatment method. Possible significant prognostic factors (i.e. tumor volume, central necrosis, pathology, age) were collected to determine whether they correlate with local disease control and survival. Results: Primary tumor volume correlated with local disease control and survival. The greatest risk for local failure was found among patients with primary tumor volumes >19.0 ml (p = 0.001). Other relatively significant prognostic factors were pathology and central necrosis. The survival rate among patients with primary tumor volumes >19.0 ml was only 39.3% compared with 78.3% for patients with volumes <19.0 ml (p = 0.036). A proportional hazard model indicated that significant parameters associated with overall survival were primary tumor volume (p = 0.036) and central necrosis (p = 0.008). According to the cancer cell differentiation, the hazard risk in the well-differentiated group was 5.62 folds higher than in the poorly differentiated group (p = 0.05). Patients with an initial complete response had a primary tumor volume <19 ml (p = 0.001, 0.016), poorly differentiated pathology (p = 0.001, 0.016), and no central necrosis (p = 0.001, 0.016). Other relatively poor significant factors were T stage above III (p = 0.047), cervical lymphadenopathy beyond level II (p = 0.046), and a nodal volume >10.0 ml (p = 0.029). N stage, age and gender were not significant prognostic factors. Conclusion: Tumor volume is the most important prognostic factor of treatment outcome for patients with hypopharyngeal cancer and should always be taken into consideration in treatment planning. Other possible prognostic factors which affect the initial complete response rate and survival rate including central necrosis, pathology, nodal number and nodal volume, T stage above III, and cervical lymphadenopathy beyond level II have a relatively low correlation with treatment outcome. In our study, there was a correlation between tumor volume and central necrosis, but no significant correlation between pathological differentiation and tumor volume, although both affect treatment outcome.

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Section: Resultsmentioning

confidence: 64%

Analysis of Prognostic Factors of Chemoradiation Therapy for Advanced Hypopharyngeal Cancer – Does Tumor Volume Correlate with Central Necrosis and Tumor Pathology?

Tsou

Mai

Lin

et al. 2006

ORL

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“…However, the method does recognize that stage at recurrence/persistence is likely more important for outcome than initial stage. 6,10,11 The Veterans Affairs laryngeal cancer study 3 randomly assigned 332 patients to either three cycles of cisplatin + fluorouracil and RT or laryngectomy with postoperative RT. Nearly all of the initial laryngectomies consisted of TL.…”

Section: Discussionmentioning

confidence: 99%

Factors influencing long-term survival following salvage total laryngectomy after initial radiotherapy or conservative surgery

et al. 2006

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“…Preservation of larynx means larynx in place, no residual tumor, and also no tracheotomy and no feeding tube. Preservation of function is more important than just anatomic integrity of the larynx [5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Survival after Salvage Total Laryngectomy: The Influence of Previous Treatment

Stanković¹,

Milisavljević²,

Stankovic³

2017

J Nucl Med Radiat Ther

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Purpose: To compare the complications and survival rate after different treatment modalities of advanced laryngopharyngeal cancer. Methods:Retrospective study included 619 advanced laryngopharyngeal carcinoma, treated with either primary total laryngectomy (PTL), or salvage (STL) after partial laryngectomy, radio, chemoradiotherapy. Complications and survival rate were documented.Results: Five years disease free survival rate amounted 60.9% for PTL, 54.3% for STL after partial laryngectomy, 50% for STL after radiotherapy and 43.8% for STL after chemoradiotherapy. Histologically positive neck was highly significantly associated with worse prognosis, much more than recurrence within larynx. Conclusion:PTL gives the best survival rate with low complications for advanced laryngopharyngeal squamous cell carcinoma. Complications and survival rate of STL significantly depend on previous treatment of laryngopharyngeal cancer.

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Salvage Surgery After Failure of Nonsurgical Therapy for Carcinoma of the Larynx and Hypopharynx

Cited by 121 publications

References 13 publications

Analysis of Prognostic Factors of Chemoradiation Therapy for Advanced Hypopharyngeal Cancer – Does Tumor Volume Correlate with Central Necrosis and Tumor Pathology?

Analysis of Prognostic Factors of Chemoradiation Therapy for Advanced Hypopharyngeal Cancer – Does Tumor Volume Correlate with Central Necrosis and Tumor Pathology?

Factors influencing long-term survival following salvage total laryngectomy after initial radiotherapy or conservative surgery

Survival after Salvage Total Laryngectomy: The Influence of Previous Treatment

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