Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-29T13:46:21.908Z Has data issue: false hasContentIssue false
  • English
  • Français

Outcomes of surgical versus non-surgical treatment of resectable T4a laryngeal and hypopharyngeal carcinoma

Published online by Cambridge University Press:  18 March 2022

S Thiagarajan Open the ORCID record for S Thiagarajan [Opens in a new window] ,
M Gupta ,
P Sathe ,
G Gill ,
S Ghosh-Laskar Open the ORCID record for S Ghosh-Laskar [Opens in a new window] ,
K Prabhash  and
D Chaukar
S Thiagarajan*
Affiliation:
Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
M Gupta
Affiliation:
Department of Surgical Oncology, HealthCare Global, Ranchi, Jharkhand, India
P Sathe
Affiliation:
Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
G Gill
Affiliation:
Department of ENT, Kothari Hospital, Bikaner, India
S Ghosh-Laskar
Affiliation:
Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
K Prabhash
Affiliation:
Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
D Chaukar
Affiliation:
Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
*
Author for correspondence: Dr S Thiagarajan, Department of Head and Neck Surgical Oncology, Tata Memorial Hospital, Parel, Mumbai400012, India E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Surgery is the recommended treatment for resectable T4a laryngeal and hypopharyngeal carcinoma. Non-surgical treatment is an option in a select few patients.

Method

This retrospective study was undertaken to assess the treatment outcomes in patients with resectable T4a carcinoma of the larynx and hypopharynx who received either surgical or non-surgical treatment at our institute and to assess factors influencing these outcomes.

Results

A total of 120 patients were included in the study. They were divided into groups A, B and C based on the presence of extralaryngeal spread through laryngeal membrane, cartilage or both. The overall survival was better among patients who received surgery than those who received non-surgical treatment in the three groups. The factor influencing overall survival was the treatment given in the form of surgical versus non-surgical treatment.

Conclusion

Surgery is the preferred treatment for T4a laryngeal and hypopharyngeal carcinoma, even in patients with extralaryngeal spread without cartilage erosion.

Keywords

Carcinoma LarynxCarcinoma HypopharynxT4aTreatment Pattern
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 11 , November 2022 , pp. 1087 - 1095
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr S Thiagarajan takes responsibility for the integrity of the content of the paper

Presented at the Foundation of Head and Neck Oncology 2020 virtual meeting, 12–13 December 2020.

References

National Comprehensive Cancer Network. Bone cancer (version 1 2021) http://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf [16 March 2021]Google Scholar
Forastiere, AA, Ismaila, N, Lewin, JS et al. Use of larynx-preservation strategies in the treatment of laryngeal cancer: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol 2018;36:1143–69CrossRefGoogle ScholarPubMed
Department of Veterans Affairs Laryngeal Cancer Study Group, Wolf, GT, Fisher, SG, Hong, WK, Hillman, R, Spaulding, M et al. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med 1991;324:1685–90Google ScholarPubMed
Lefebvre, JL, Chevalier, D, Luboinski, B et al. Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. J Natl Cancer Inst 1996;88:890–99CrossRefGoogle ScholarPubMed
Forastiere, AA, Goepfert, H, Maor, M et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med 2003;349:2091–8CrossRefGoogle ScholarPubMed
Silverman, DA, Puram, SV, Rocco, JW, Old, MO, Kang, SY. Salvage laryngectomy following organ-preservation therapy - an evidence-based review. Oral Oncol 2019;88:137–44CrossRefGoogle ScholarPubMed
Edge, SB, Byrd, DR, Compton, CC, Fritz, AG, Greene, FL, Trotti, A, eds. AJCC Cancer Staging Manual, 7th edn. New York: Springer, 2010Google ScholarPubMed
Iyer, NG, Tan, DS, Tan, VK, Wang, W, Hwang, J, Tan, N-C et al. Randomized trial comparing surgery and adjuvant radiotherapy versus concurrent chemoradiotherapy in patients with advanced, nonmetastatic squamous cell carcinoma of the head and neck: 10-year update and subset analysis. Cancer 2015;121:1599–607CrossRefGoogle ScholarPubMed
National Library of Medicine (US). Concurrent chemoradiation versus surgery with adjuvant therapy in advanced laryngopharyngeal cancers (NCT00128817). In: http://clinicaltrials.gov/ct/show/ [21 October 2021]Google Scholar
Hoffman, HT, Porter, K, Karnell, LH, Cooper, JS, Weber, RS, Langer, CJ et al. Laryngeal cancer in the United States: changes in demographics, patterns of care, and survival. Laryngoscope 2006;116:1–13CrossRefGoogle Scholar
Choi, YS, Park, SG, Song, EK, Cho, S-H, Park, M-R, Park, K U et al. Comparison of the therapeutic effects of total laryngectomy and a larynx-preservation approach in patients with T4a laryngeal cancer and thyroid cartilage invasion: a multicenter retrospective review. Head Neck 2016;38:1271–7CrossRefGoogle Scholar
Rosenthal, DI, Mohamed, AS, Weber, RS, Garden, AS, Sevak, PR, Kies, MS et al. Long-term outcomes after surgical or nonsurgical initial therapy for patients with T4 squamous cell carcinoma of the larynx: a 3-decade survey. Cancer 2015;121:1608–19CrossRefGoogle ScholarPubMed
Vengalil, S, Giuliani, ME, Huang, SH, McNiven, A, Song, Y, Xu, W et al. Clinical outcomes in patients with T4 laryngeal cancer treated with primary radiotherapy versus primary laryngectomy. Head Neck 2016;38:2035–40CrossRefGoogle ScholarPubMed
Al-Mamgani, A, Navran, A, Walraven, I, Schreuder, WH, Tesselaar, MET, Klop, WMC. Organ-preservation (chemo)radiotherapy for T4 laryngeal and hypopharyngeal cancer: is the effort worth? Eur Arch Otorhinolaryngol 2019;276:575–83CrossRefGoogle ScholarPubMed
Dyckhoff, G, Plinkert, PK, Ramroth, H. A change in the study evaluation paradigm reveals that larynx preservation compromises survival in T4 laryngeal cancer patients. BMC Cancer 2017;17:609CrossRefGoogle Scholar
Dziegielewski, PT, O'Connell, DA, Klein, M, Fung, C, Singh, P, Mlynarek, MA et al. Primary total laryngectomy versus organ preservation for T3/T4a laryngeal cancer: a population-based analysis of survival. J Otolaryngol Head Neck Surg 2012;41:56–64Google ScholarPubMed
Gourin, CG, Conger, BT, Sheils, WC, Bilodeau, PA, Coleman, TA, Porubsky, ES. The effect of treatment on survival in patients with advanced laryngeal carcinoma. Laryngoscope 2009;119:1312–17CrossRefGoogle ScholarPubMed
Megwalu, UC, Sikora, AG. Survival outcomes in advanced laryngeal cancer. JAMA Otolaryngol Head Neck Surg 2014;140:855–60CrossRefGoogle ScholarPubMed
Grover, S, Swisher-McClure, S, Mitra, N, Li, J, Cohen, RB, Ahn, PH et al. Total laryngectomy versus larynx preservation for T4a larynx cancer: Patterns of care and survival outcomes. Int J Radiat Oncol Biol Phys 2015;92:594–601CrossRefGoogle ScholarPubMed
Stokes, WA, Jones, BL, Bhatia, S, Oweida, AJ, Bowles, DW, Raben, D et al. A comparison of overall survival for patients with T4 larynx cancer treated with surgical versus organ-preservation approaches: a National Cancer Data Base analysis. Cancer 2017;123:600–8CrossRefGoogle ScholarPubMed
Daneshi, N, Fararouei, M, Mohammadianpanah, M, Zare-Bandamiri, M, Parvin, S, Dianatinasab, M. Effects of different treatment strategies and tumor stage on survival of patients with advanced laryngeal carcinoma: a 15-year cohort study. J Cancer Epidemiol 2018;2018:9678097CrossRefGoogle ScholarPubMed
Calvas, OIJ, Ramos, DM, Matos, LL, Kulcsar, MAV, Dedivitis, RA, Brandao, LG et al. Oncological results of surgical treatment versus organ-function preservation in larynx and hypopharynx câncer. Rev Assoc Med Bras (1992). 2017;63:1082–9CrossRefGoogle ScholarPubMed
Kim, YJ, Lee, R. Surgery vs. radiotherapy for locally advanced hypopharyngeal cancer in the contemporary era: a population-based study. Cancer Med 2018;7:5889–900Google ScholarPubMed
Bradford, CR. Predictive factors in head and neck cancer. Hematol Oncol Clin North Am 1999;13:777–85CrossRefGoogle ScholarPubMed
Parsons, JT, Mendenhall, WM, Stringer, SP, Cassisi, NJ, Million, RR. Salvage surgery following radiation failure in squamous cell carcinoma of the supraglottic larynx. Int J Radiat Oncol Biol Phys 1995;32:605–9CrossRefGoogle ScholarPubMed
Forastiere, AA, Zhang, Q, Weber, RS, Maor, MH, Goepfart, H, Pajak, TF et al. Long-term results of RTOG 91-11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol 2013;31:845–52CrossRefGoogle ScholarPubMed
Sharma, A, Jagadesan, P, Chaudhari, P, Das, S, Bhaskar, S Thakar, A et al. Six-year analysis of compliance to weekly concurrent chemoradiotherapy in head and neck carcinomas. Clin Otolaryngol 2016;41:442–7CrossRefGoogle ScholarPubMed
Muzumder, S, Srikantia, N, Udayashankar, AH, Kainthaje, PB, John Sebastian, MG. Burden of acute toxicities in head-and-neck radiation therapy: a single institutional experience. South Asian J Cancer 2019;8:120–3Google ScholarPubMed
Hanna, E, Sherman, A, Cash, D, Adams, D, Vural, E, Fan, C-Y et al. Quality of life for patients following total laryngectomy vs chemoradiation for laryngeal preservation. Arch Otolaryngol Head Neck Surg 2004;130:875–9CrossRefGoogle ScholarPubMed
Trivedi, NP, Swaminathan, DK, Thankappan, K, Chatni, S, Kuriakose, MA, Iyer, S. Comparison of quality of life in advanced laryngeal cancer patients after concurrent chemoradiotherapy vs total laryngectomy. Otolaryngol Head Neck Surg 2008;139:702–7CrossRefGoogle ScholarPubMed