Surgery versus radiotherapy: Long term outcomes of T1 glottic cancer

Ferreira, Nelson P.; Netto, E.; Fonseca, Leonor; Fonseca, João; Esteves, Susana; Labareda, M.; Mota, Alberto; Pocinho, R.; Magalhães, Miguel; Santos, F.

doi:10.1016/j.rpor.2020.08.007

Cited by 9 publications

(3 citation statements)

References 27 publications

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“…The choice for the best treatment differs per patient and should be made during a shared decision‐making process. Although all treatment modalities have comparable and good five‐year survival rates, 4‐9 they differ in duration, side effects, laryngeal preservation, and functional outcomes 4‐7,10‐16 . TLM is performed in 1 session and enables targeted resection and preservation of tissue.…”

mentioning

confidence: 99%

Longitudinal Patient‐Reported Voice Quality in Early‐Stage Glottic Cancer

Dorr

Sewnaik

Andrinopoulou

et al. 2023

Otolaryngol.--head neck surg.

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Objective. Patient-reported voice quality is an important outcome during counseling in early-stage glottic cancer. However, there is a paucity of adequate longitudinal studies concerning voice outcomes. This study aimed to investigate longitudinal trajectories for patient-reported voice quality and associated risk factors for treatment modalities such as transoral CO 2 laser microsurgery, single vocal cord irradiation, and local radiotherapy.Study Design. A longitudinal observational cohort study. Setting. Tertiary cancer center.Methods. Patients treated for Tcis-T1b, N0M0 glottic cancer were included in this study (N = 294). The Voice Handicap Index was obtained at baseline and during follow-up (N = 1944). Mixed-effects models were used for investigating the different trajectories for patient-reported voice quality.Results. The mean follow-up duration was 43.4 (SD 21.5) months. Patients received transoral CO 2 laser microsurgery (57.8%), single vocal cord irradiation (24.5%), or local radiotherapy (17.5%). A steeper improvement during the first year after treatment for single vocal cord irradiation (−15.7) and local radiotherapy (−12.4) was seen, compared with a more stable trajectory for laser surgery (−6.1). All treatment modalities showed equivalent outcomes during long-term follow-up. Associated risk factors for different longitudinal trajectories were age, tumor stage, and comorbidity. Conclusion.Longitudinal patient-reported voice quality after treatment for early-stage glottic cancer is heterogeneous and nonlinear. Most improvement is seen during the first year of follow-up and differs between treatment modalities. No clinically significant differences in longterm trajectories were found. Insight into longitudinal trajectories can enhance individual patient counseling and provide the foundation for an individualized dynamic prediction model.

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confidence: 99%

Longitudinal Patient‐Reported Voice Quality in Early‐Stage Glottic Cancer

Dorr

Sewnaik

Andrinopoulou

et al. 2023

Otolaryngol.--head neck surg.

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“…La MTL ha ganado terreno y se ha establecido como una opción efectiva para el manejo de tumores glóticos tempranos. Lo anterior se debe a que presenta tasas de efectividad equivalentes a la cirugía abierta y a la radioterapia, y tiene muchas ventajas en comparación con estas últimas, como son una menor morbilidad, menor tiempo de hospitalización y mayor preservación del órgano (14)(15)(16).…”

Section: Introductionunclassified

Márgenes histopatológicos positivos: ¿se relacionan siempre con recidiva tumoral en carcinoma glótico temprano?

Chemas-Velez

Jimenez-Fandiño²,

Díaz-Oliveros³

et al. 2022

Iatreia

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Introducción: el carcinoma escamocelular de laringe es una de las neoplasias más comunes en cabeza y cuello. En sus estadios tempranos se caracteriza por presentar buen pronóstico oncológico, por lo que el manejo se enfoca no solo en la enfermedad oncológica sino también en la preservación de las funciones laríngeas. La microcirugía transoral con láser de CO2 (MTL) presenta tasas de efectividad equivalentes a la cirugía abierta y a la radioterapia, y tiene muchas ventajas si se compara con las otras modalidades de tratamiento. Objetivo: el objetivo de este estudio fue revisar los resultados oncológicos obtenidos con el tratamiento de una serie de tumores glóticos tempranos tratados mediante MTL en un hospital universitario de tercer nivel. Métodos: revisión retrospectiva de las historias clínicas de pacientes con diagnóstico de carcinoma escamocelular de laringe en estadio temprano que fueron llevados a MTL en un hospital de tercer nivel, entre enero del 2012 y diciembre del 2019. Resultados: en total, 48 pacientes cumplieron con los criterios de inclusión: 91,7 % hombres y 8,3 % mujeres. La edad promedio al diagnóstico fue 64,4 ± 13,3 años (min.: 36/máx.: 88). De estos, el 83,3 % tenía antecedente de tabaquismo. La tasa de preservación del órgano o supervivencia laríngea fue del 93,7 %. El 83 % de los pacientes que no presentaron recidiva tumoral tuvieron márgenes quirúrgicos positivos. Conclusiones: la MTL es una alternativa terapéutica para tumores laríngeos en estadios tempranos. El análisis de los márgenes quirúrgicos debe ser cuidadoso y se recomienda hacer un seguimiento cercano a todos los pacientes.

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“…Early‐stage glottic cancer (ESGC) is a common malignancy of the head and neck area with a good overall clinical outcome in terms of survival and recurrent disease. However, the tumor and its treatment have a significant impact on patient‐reported quality of voice 1‐11 . Voice and speech are crucial aspects of social communication and interaction and therefore can impact a patient's psychosocial well‐being as well.…”

mentioning

confidence: 99%

Individualized Dynamic Prediction Model for Patient‐Reported Voice Quality in Early‐Stage Glottic Cancer

Dorr

Andrinopoulou

Sewnaik

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveEarly‐stage glottic cancer (ESGC) is a malignancy of the head and neck. Besides disease control, preservation and improvement of voice quality are essential. To enable expectation management and well‐informed decision‐making, patients should be sufficiently counseled with individualized information on expected voice quality. This study aims to develop an individualized dynamic prediction model for patient‐reported voice quality. This model should be able to provide individualized predictions at every time point from intake to the end of follow‐up.Study DesignLongitudinal cohort study.SettingTertiary cancer center.MethodsPatients treated for ESGC were included in this study (N = 294). The Voice Handicap Index was obtained prospectively. The framework of mixed and joint models was used. The prognostic factors used are treatment, age, gender, comorbidity, performance score, smoking, T‐stage, and involvement of the anterior commissure. The overall performance of these models was assessed during an internal cross‐validation procedure and presentation of absolute errors using box plots.ResultsThe mean age in this cohort was 67 years and 81.3% are male. Patients were treated with transoral CO2 laser microsurgery (57.8%), single vocal cord irradiation up to (24.5), or local radiotherapy (17.5%). The mean follow‐up was 43.4 months (SD 21.5). Including more measurements during prediction improves predictive performance. Including more clinical and demographic variables did not provide better predictions. Little differences in predictive performance between models were found.ConclusionWe developed a dynamic individualized prediction model for patient‐reported voice quality. This model has the potential to empower patients and professionals in making well‐informed decisions and enables tailor‐made counseling.

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Surgery versus radiotherapy: Long term outcomes of T1 glottic cancer

Cited by 9 publications

References 27 publications

Longitudinal Patient‐Reported Voice Quality in Early‐Stage Glottic Cancer

Longitudinal Patient‐Reported Voice Quality in Early‐Stage Glottic Cancer

Márgenes histopatológicos positivos: ¿se relacionan siempre con recidiva tumoral en carcinoma glótico temprano?

Individualized Dynamic Prediction Model for Patient‐Reported Voice Quality in Early‐Stage Glottic Cancer

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