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Treatment outcomes of laryngectomy compared to non-surgical management of T3 laryngeal carcinomas: a 10-year multicentre audit of 179 patients in the northeast of England

Published online by Cambridge University Press:  12 January 2021

D J Lin ,
M Goodfellow ,
J Ong ,
M Y Chin ,
L Lazarova  and
H C Cocks
D J Lin*
Affiliation:
ENT Department, City Hospitals Sunderland NHS Foundation Trust, Sunderland, UK ENT Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
M Goodfellow
Affiliation:
Newcastle Medical School, Newcastle University, Newcastle upon Tyne, UK
J Ong
Affiliation:
ENT Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
M Y Chin
Affiliation:
ENT Department, North Cumbria University Hospital, Carlisle, UK
L Lazarova
Affiliation:
ENT Department, North Cumbria University Hospital, Carlisle, UK
H C Cocks
Affiliation:
ENT Department, City Hospitals Sunderland NHS Foundation Trust, Sunderland, UK
*
Author for correspondence: Mr Daniel J Lin, ENT Department, Sunderland Royal Hospital, Kayll Road, SunderlandSR4 7TP, UK E-mail: [email protected]
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Abstract

Objective

Wide-ranging outcomes have been reported for surgical and non-surgical management of T3 laryngeal carcinomas. This study compared the outcomes of T3 tumours treated with laryngectomy or (chemo)radiotherapy in the northeast of England.

Methods

The outcomes of T3 laryngeal carcinoma treatment at three centres (2007–2016) were retrospectively analysed using descriptive statistics and survival curves.

Results

Of 179 T3 laryngeal carcinomas, 68 were treated with laryngectomies, 57 with chemoradiotherapy and 32 with radiotherapy. There was no significant five-year survival difference between treatment with laryngectomy (34.1 per cent) and chemoradiotherapy (48.6 per cent) (p = 0.184). The five-year overall survival rate for radiotherapy (12.5 per cent) was significantly inferior compared to laryngectomy and chemoradiotherapy (p = 0.003 and p < 0.001, respectively). The recurrence rates were 22.1 per cent for laryngectomy, 17.5 per cent for chemoradiotherapy and 50 per cent for radiotherapy. There were significant differences in recurrence rates when laryngectomy (p = 0.005) and chemoradiotherapy (p = 0.001) were compared to radiotherapy.

Conclusion

Laryngectomy and chemoradiotherapy had significantly higher five-year overall survival and lower recurrence rates compared with radiotherapy alone. Laryngectomy should be considered in patients unsuitable for chemotherapy, as it may convey a significant survival advantage over radiotherapy alone.

Keywords

LarynxLaryngectomyOutcomes ResearchSurvival AnalysisHead And Neck Cancer
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 12 , December 2020 , pp. 1103 - 1107
Copyright
Copyright © JLO (1984) Limited, 2021

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Footnotes

Mr D Lin takes responsibility for the integrity of the content of the paper

References

Health and Social Care Information Centre. National Head and Neck Cancer Audit 2014. Leeds: Health and Social Care Information Centre, 2015Google Scholar
Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991;324:1685–90CrossRefGoogle Scholar
Fuller, CD, Mohamed, ASR, Garden, AS, Gunn, GB, Mulcahy, CF, Zafereo, M et al. Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: improved functional outcomes and survival with modern therapeutic approaches. Head Neck 2016;38:1739–51CrossRefGoogle ScholarPubMed
Timme, DW, Jonnalagadda, S, Patel, R, Rao, K, Robbins, KT. Treatment selection for T3/T4a laryngeal cancer: chemoradiation versus primary surgery. Ann Otol Rhinol Laryngol 2015;124:845–51CrossRefGoogle ScholarPubMed
Al-Gilani, M, Skillington, S, Kallogjeri, D, Haughey, B, Piccirillo, J. Surgical vs nonsurgical treatment modalities for T3 glottic squamous cell carcinoma. JAMA Otolaryngol Head Neck Surg 2016;142:940–6CrossRefGoogle ScholarPubMed
Scherl, C, Mantsopoulos, K, Semrau, S, Fietkau, R, Kapsreiter, M, Koch, M et al. Management of advanced hypopharyngeal and laryngeal cancer with and without cartilage invasion. Auris Nasus Larynx 2017;44:333–9CrossRefGoogle ScholarPubMed
Massa, ST, Osazuwa-Peters, N, Franco, J, Ward, GW, Walker, RJ. Survival after refusal of surgical treatment for locally advanced laryngeal cancer. Oral Oncol 2017;71:34–40CrossRefGoogle ScholarPubMed
Hamilton, DW, McMeekin, PJ, Dyson, P, Robson, AK. Laryngeal cancer management in a small, rural, multidisciplinary team setting: 15-year review. J Laryngol Otol 2013;127:1203–7CrossRefGoogle Scholar
Hamilton, DW, Bins, JE, McMeekin, P, Pederson, A, Steen, N, De Soyza, A et al. Quality compared to quantity of life in laryngeal cancer: a time trade-off study. Head Neck 2016;38:E631–7CrossRefGoogle ScholarPubMed
Jones, TM, De, M, Foran, B, Harrington, K, Mortimore, S. Laryngeal cancer: United Kingdom National Multidisciplinary guidelines. J Laryngol Otol 2016;130:S75–82CrossRefGoogle ScholarPubMed
Machtay, M, Moughan, J, Trotti, A, Garden, AS, Weber, RS, Cooper, JS et al. Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J Clin Oncol 2008;26:3582–9CrossRefGoogle ScholarPubMed
Pignon, J-P, le Maître, A, Maillard, E, Bourhis, J, MACH-NC Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother Oncol 2009;92:4–14CrossRefGoogle ScholarPubMed