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Arch Otolaryngol Head Neck Surg. 2004 Sep;130(9):1092-9.

Local control after supracricoid partial laryngectomy for "advanced" endolaryngeal squamous cell carcinoma classified as T3.

Author information

1
Department of Otorhinolaryngology-Head and Neck Surgery, Hôpital Européen Georges Pompidou, Assistance Publique des Hôpitaux de Paris, University of Paris V, Paris, France.

Abstract

OBJECTIVES:

To determine the incidence of local control in patients with "advanced" moderately to well-differentiated endolaryngeal invasive squamous cell carcinoma classified as T3, treated with a supracricoid partial laryngectomy; to identify any statistical relationship; and to analyze the consequences of local recurrence.

DESIGN:

Retrospective nonrandomized case series.

SETTING:

A tertiary referral care center and university teaching hospital.

PATIENTS:

An inception cohort of 118 patients. Tumor stage was T3 N0 M0 in 90 patients, T3 N1 M0 in 21 patients, T3 N2 M0 in 5 patients, and T3 N3 M0 in 2 patients.

INTERVENTIONS:

All patients underwent supracricoid partial laryngectomy. A platin-based induction chemotherapy regimen was used in 100 patients. Postoperative radiotherapy was used for 24 patients.

MAIN OUTCOME MEASURES:

Local recurrence, nodal recurrence, distant metastasis, and survival; univariate and multivariate analysis of local recurrence.

RESULTS:

Nine patients developed a local recurrence. The 1-, 3-, and 5-year actuarial local control estimates were 97.3%, 93.5%, and 91.4%, respectively. In a stepwise regression model, the presence of positive margins of resection was the only variable that statistically increased the risk of local recurrence (P =.008). Local recurrence resulted in a significant increase in nodal recurrence (P<.001) and distant metastasis (P<.001) and a significant decrease in survival (P =.03). An overall 89.8% laryngeal preservation rate and 98.3% local control rate were achieved.

CONCLUSION:

Supracricoid partial laryngectomies should be considered when an organ preservation strategy is discussed in patients with advanced endolaryngeal squamous cell carcinoma classified as T3.

PMID:
15381597
DOI:
10.1001/archotol.130.9.1092
[Indexed for MEDLINE]
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