Outcomes of the modern management approach for locally advanced (T₃-T₄) laryngeal cancer: a retrospective cohort study.

IF 1.1 4区医学 Q3 OTORHINOLARYNGOLOGY Journal of Laryngology and Otology Pub Date : 2024-12-01 Epub Date: 2024-10-21 DOI:10.1017/S0022215124001105

Amarkumar Dhirajlal Rajgor, Josh Cowley, Colin Gillespie, Chang Woo Lee, James O'Hara, Muhammad Shahid Iqbal, David Winston Hamilton

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Abstract

Background: Our centre (Freeman Hospital, Newcatle Upon Tyne NHS Trust) has favoured primary surgery over chemoradiotherapy for specific advanced laryngeal cancer patients (e.g. large-volume tumours, airway compromise, significant dysphagia, T₄ disease). This study reports the survival outcomes for a modern, high-volume head and neck centre favouring surgical management to determine whether this approach improves survival.

Method: Retrospective analysis of patient data over a seven-year period from a tertiary cancer centre.

Results: In total, 121 patients were identified with T₃ (n = 76) or T₄ (n = 45) laryngeal cancer (mean follow up 2.9 years). In the cohort treated with curative intent (n = 104, 86.0 per cent), the 2- and 5-year estimated disease-specific survival rates were 77.9 and 64.1 per cent. chemoradiotherapy had the highest 2-year disease-specific survival (92.5 per cent), followed by surgery with adjuvant therapy (81.8 per cent), radiotherapy alone (75 per cent) and surgery alone (72.4 per cent).

Conclusion: For a centre favouring primary surgery for certain advanced laryngeal cancers, the disease-specific survival appears no higher than that found in the published literature. To enhance survival, future research should focus on precision medicine to define treatment pathways in this disease.

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局部晚期（T3-T4）喉癌现代治疗方法的疗效：一项回顾性队列研究。

背景：我们的中心（Freeman医院，Newcatle Upon Tyne NHS Trust）对于特定的晚期喉癌患者（如大体积肿瘤，气道受损，严重吞咽困难，T4疾病）更倾向于初级手术而不是放化疗。本研究报告了现代大容量头颈部中心的生存结果，以确定手术治疗是否能提高生存率。方法：回顾性分析某三级肿瘤中心7年的患者资料。结果：121例患者确诊为T3（76例）或T4（45例）喉癌（平均随访2.9年）。在以治疗目的治疗的队列中（n = 104, 86.0%）， 2年和5年的估计疾病特异性生存率分别为77.9%和64.1%。放化疗的2年疾病特异性生存率最高（92.5%），其次是手术辅助治疗（81.8%），单独放疗（75%）和单独手术（72.4%）。结论：对于一个支持对某些晚期喉癌进行原发性手术的中心来说，疾病特异性生存率似乎并不高于已发表的文献。为了提高生存率，未来的研究应侧重于精准医学，以确定该疾病的治疗途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Laryngology and Otology 医学-耳鼻喉科学

CiteScore

3.20

自引率

11.80%

发文量

593

审稿时长

3-6 weeks

期刊介绍： The Journal of Laryngology & Otology (JLO) is a leading, monthly journal containing original scientific articles and clinical records in otology, rhinology, laryngology and related specialties. Founded in 1887, JLO is absorbing reading for ENT specialists and trainees. The journal has an international outlook with contributions from around the world, relevant to all specialists in this area regardless of the country in which they practise. JLO contains main articles (original, review and historical), case reports and short reports as well as radiology, pathology or oncology in focus, a selection of abstracts, book reviews, letters to the editor, general notes and calendar, operative surgery techniques, and occasional supplements. It is fully illustrated and has become a definitive reference source in this fast-moving subject area. Published monthly an annual subscription is excellent value for money. Included in the subscription is access to the JLO interactive web site with searchable abstract database of the journal archive back to 1887.