pT3 N0 Laryngeal Squamous Cell Carcinoma: Oncologic Outcomes and Prognostic Factors of Surgically Treated Patients

Abstract

Objectives/Hypothesis: To assess the disease control, survival rates, and prognostic factors of exclusive surgical treatment for patients with pT3 N0 laryngeal squamous cell carcinoma (LSCC).Study Design: Multicentric retrospective cohort study. Methods: Multicentric retrospective case series of previously untreated patients with pT3 R0N0 LSCC, who received exclusive surgery between 2011 and 2019. Tumor location; subsite involvement; grading; and lymphatic, vascular, and perineural invasion were reported. Overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were measured.Results: Fifty-four patients (mean age 67.1; male sex 83.3%; mean follow-up period 37 months) underwent total laryngectomy (48.1%) or partial laryngectomy (51.9%). Ipsilateral or bilateral neck dissection was performed in 46 (85.2%) cases. Perineural invasion was more frequent in case of supraglottic involvement than glottic involvement (85.7% vs. 14.3%, P = .03). Five (9.3%) patients experienced recurrence (3 local recurrences, 1 nodal recurrence, 1 distant recurrence). Rate of recurrence differed between glottic (0%), supraglottic (80%), and transglottic (20%) tumors (P = .01), with a lower risk yielded by glottic involvement (odds ratio [OR], 0.05, 95% confidence interval [95% CI], 0.01-0.56, P = .01). A higher risk was recorded in case of perineural invasion (OR, 66.0, 95% CI, 1.41-3085.3, P = .03). The OS, DSS, and DFS were 79.6%, 96.3%, and 90.7%, without differences regarding the type of surgery. The DFS was lower in case of supraglottic involvement when compared to purely glottic LSCC (83.9% vs. 100%, P = 0.02).Conclusions: Exclusive surgery is a safe option for patients with pT3 R0N0 LSCC. Adjuvant treatments or closer followup monitoring might be considered in case of supraglottic involvement or perineural invasion.

Partial laryngectomy for naïve pT3N0 laryngeal cancer: Systematic review on oncological outcomes

“…Citation searches did not identify other relevant articles. The final review was conducted on six studies (Table S2), published between 2012 and 2022 7,9–14 …”

Our surgical treatment results in pT3N0 laryngeal squamous cell carcinoma

“…Total larenjektomi veya KRT seçeneklerine alternatif olarak açık ve kapalı teknik parsiyel larenjektomiler de ön plana çıkmaktadır. [5] Üç farklı tedavi seçeneğinde de benzer sonuçlar bildirilse de, [6] cerrahi tedavi modalitesinin daha başarılı olduğunu gösteren çalışmalar bulunmaktadır. [7,8] Soudry ve ark.…”

“…Tümör yerleşim yerinin sağkalım üzerine etkisine baktığımızda literatürde özellikle glottik seviyedeki tümörlerde sağkalımın daha iyi olduğunu görmekteyiz. [5] Bizim çalışmamızda ise supraglottik bölge kaynaklı tümörlerde beş yıllık genel sağkalım oranlarının glottik bölge tümörlerine kıyasla daha iyi olduğu görülmektedir. Çalışmamızdaki glottik bölge kaynaklı tümörü olan hastalardan ikisinin cerrahi sonrasındaki ilk ay içerisinde hayatını kaybetme nedeninin komorbit hastalıklarına bağlı olduğunu düşünmekteyiz.…”

Oncological Outcomes of Primary vs. Salvage OPHL Type II: A Systematic Review

“…The following information was selected from chosen articles: authors, year of publication, number of included patients, follow-up duration (months), OS, DFS, DSS, LC, LP, LR. Data were collected on data spreadsheet using Microsoft Excel (version 16.47.1).OS is the time between surgery and death by any cause or last follow-up; DSS is the interval time between surgery and death from the disease; DFS is the time from surgery to tumor recurrence; LC is the length of time from surgery to relapse on the primary tumor site; LP is the interval time between OPHL to total laryngectomy; LR is the time between surgery and the first local recurrence [14,15].…”