Treatment with preoperative irradiation and surgery of squamous cell carcinoma of the head and neck

Wang, Zhonghe; Million, Rodney R.; Mendenhall, William M.; Parsons, James T.; Cassisi, Nicholas J.

doi:10.1002/1097-0142(19890701)64:1<32::aid-cncr2820640107>3.0.co;2-p

Cited by 18 publications

(5 citation statements)

References 14 publications

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“…Thus, many years of clinical experience clearly demonstrate that postoperative radiotherapy in patients with advanced laryngeal cancer is an effective treatment. Numerous literature reports confirm that the main predictive factors are related to intraoperative and histopathological evaluation of the surgical specimen [13,16,17,18,19,21,29,31,32,33,34,35,36,37,38,39,40].…”

Section: Discussionmentioning

confidence: 96%

“…Layland et al [28] observed reduced survival in patients with N+ disease compared to N0. Wang et al [38] found a significant decrease of long-lasting LC from 88% for N0 to 49% if the postoperative material contained more than 3 metastatic lymph nodes. However, Parsons et al [37] and Peters et al [17] did not demonstrate independent prognostic significance of the number of involved lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

“…Jacobs et al [36] observed a two-fold more frequent development of locoregional recurrence in patients with laryngeal cancer who had undergone macroscopically non-radical surgery. Most reports indicate that histologically negative margin is associated with a 30% decrease of the recurrence risk following combined treatment (surgery with subsequent radiotherapy) [13,17,18,21,29,37,38]. Hinerman et al [29] noted that 5-year DFS decreased from 89% to 56% in the case of positive margins.…”

Section: Discussionmentioning

confidence: 99%

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Histopathological factors influencing results of combined treatment in patients with laryngeal cancer

Mucha-Małecka¹,

Składowski²,

Lange³

2015

pjp

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The aim of the study was to assess the prognostic value of postoperative histopathological factors as well as the clinical usefulness of the modified risk score for recurrence. In a group of 197 patients with laryngeal cancer who underwent surgery followed by radiation therapy, partial resection was performed in 21.5% of patients and total resection in 78.5%. The majority of patients had T3 or T4 (74%) and N0 (63%) cancer. Macroscopically positive margins were reported in 10% of patients after partial resection and in 7% of patients after total resection, whereas microscopically positive margins were observed in 31% and 20% of cases, respectively. Extracapsular extension was observed in 22% of patients. In order to estimate local and nodal recurrence risk rates, criteria developed by Peters were used. Five-year local control (LC) was achieved in 88% of patients, disease-free survival (DFS) in 68% of patients and overall survival (OS) in 73% of patients. In the case of macroscopically positive margins, the 5-year DFS was 33% lower compared to radical surgery and 25% lower in the case of microscopically positive margins. The 5-year DFS was reduced by 29% due to extracapsular extension. Cox model analysis indicated that the degree of recurrence risk was the most potent independent prognostic factor for postoperative radiation therapy in laryngeal cancer. Negative histopathological factors influencing results of combined treatment of laryngeal cancer include macro-and microscopically positive margins, neck lymph node involvement and extracapsular extension.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Histopathological factors influencing results of combined treatment in patients with laryngeal cancer

Mucha-Małecka¹,

Składowski²,

Lange³

2015

pjp

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“…1,11 Several sources have demonstrated higher rates of wound complications after head and neck oncologic surgery in patients who were previously treated with radiotherapy or chemoradiotherapy. [12][13][14] Irrespective of previous adjuvant treatment, SND has been shown to cause less patient morbidity than modified radical neck dissection. 2,15 For these reasons, a protocol that minimizes the extent of surgery without compromising tumor control would be beneficial in previously irradiated patients.…”

Section: Discussionmentioning

confidence: 99%

Recurrence Rates After Selective Neck Dissection in the N0 Irradiated Neck

Fritz¹,

Esclamado²,

Lorenz³

et al. 2002

Arch Otolaryngol Head Neck Surg

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In this small cohort, SND in previously irradiated patients with recurrent primary disease but clinically negative necks has resulted in excellent tumor control in the neck. The usual patterns of nodal spread do not appear to be significantly altered with primary site recurrence after radiation therapy. The presence of more than 2 positive nodes in the neck specimen correlates with poor prognosis.

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“…In addition to physical examination, computed tomography (CT) had been used in recent years to select favorable, lowvolume lesions for treatment by RT or supraglottic laryngectomy and high-volume lesions for total laryngectomy [6]. Patients who had advanced neck disease with fixed, incompletely resectable adenopathy were treated with either RT alone followed by a neck dissection or preoperative irradiation and surgery [7]. For patients receiving combined ther-apy, there was generally a 2-6-week interval between surgery and irradiation or vice versa.…”

Section: Methodsmentioning

confidence: 99%

T2‐T3 carcinoma of the supraglottic larynx: A comparison of surgery and radiotherapy

Fein

Nichols

Lee

et al. 1994

Radation Oncology Invest

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This paper compares results for T2-T3 carcinoma of the supraglottic larynx treated with radiotherapy (RT), supraglottic laryngectomy, or total laryngectomy. Two hundred thirty patients with T2-T3 carcinoma of the supraglottic larynx were treated at the University of Florida between 1964 and 1989. All had a minimum 2-year follow-up. Patients were treated with RT alone (160), supraglottic laryngectomy (25), or total laryngectomy (45). The probabilities of local control, local-regional control, distant metastasis, and survival were calculated by the Kaplan-Meier product-limit method and comparisons were made between the three treatment methods. American Joint Committee on Cancer (AJCC) stage, T stage, anatomic suitability for a supraglottic laryngectomy, treatment group, and presence or absence of a pretreatment tracheostomy were evaluated in multivariate analyses for the various end points. The 2-year local control rates for patients treated with RT alone, supraglottic laryngectomy, and total laryngectomy for T 2 lesions were 87%, 82%, and loo%, respectively, and rates forT3 lesions were 70%, 71%, and 81%. In the multivariate analyses, T stage was of independent prognostic significance for the end point of local control, whereas AJCC stage was a significant prognostic factor for control above the clavicles and cause-specific survival. The incidence of severe complications was as follows: RT (6%), supraglottic laryngectomy (20%), and total laryngectomy (16%). In this analysis of T2-T3 supraglottic larynx carcinomas, treatment with RT offered equivalent local control rates, local-regional control rates, and survival rates with fewer severe complications compared with supraglottic laryngectomy. Although total laryngectomy was associated with a modest improvement in local-regional control, the differences were not statistically significant, and this procedure would rarely be indicated today for T 2 lesions and uncommonly for T 3 lesions. Radiut Oncol Invest 1995;2:237-244. o 1995 Wiey-Liss, hc.

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Treatment with preoperative irradiation and surgery of squamous cell carcinoma of the head and neck

Cited by 18 publications

References 14 publications

Histopathological factors influencing results of combined treatment in patients with laryngeal cancer

Histopathological factors influencing results of combined treatment in patients with laryngeal cancer

Recurrence Rates After Selective Neck Dissection in the N0 Irradiated Neck

T2‐T3 carcinoma of the supraglottic larynx: A comparison of surgery and radiotherapy

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