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Clinical outcomes in patients with T4 laryngeal cancer treated with primary radiotherapy versus primary laryngectomy
Author(s) -
Vengalil Salil,
Giuliani Meredith E.,
Huang Shao Hui,
McNiven Andrea,
Song Yuyao,
Xu Wei,
Chan Biu,
Hope Andrew,
Cho John,
Bayley Andrew,
Ringash Jolie,
Goldstein David,
Razak Albiruni,
Irish Jonathan,
Gilbert Ralph,
Gullane Patrick,
Waldron John,
Kim John,
O'Sullivan Brian
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24374
Subject(s) - medicine , laryngectomy , radiation therapy , surgery , primary treatment , primary tumor , head and neck cancer , cancer , larynx , metastasis
Background The purpose of this study was to determine the clinical outcomes of T4 laryngeal cancers. Methods T4 laryngeal cancers treated with curative intent from January 2003 to December 2010 were analyzed. Outcomes were evaluated in both primary radiotherapy (+/− chemotherapy) (RT/CRT) and primary surgery cohorts. Results Among the 65 primary RT/CRT and 42 primary surgery patients included, median follow‐up was 4.4 years. There was a trend for improved locoregional control with surgery (74% vs 88%; p = .08). In the RT/CRT group the 3‐year laryngectomy‐free survival was 67%. The 2‐year gastrostomy dependency rate was 23% with RT/CRT versus 6% with primary surgery ( p = .07). Overall survival (OS) at 3 years was significantly lower in the RT/CRT versus primary surgery group (41% vs 70%; p < .01). Conclusion Laryngeal preservation is achieved in over two thirds of patients with primary RT/CRT. Patients with low volume minimal cartilage involvement T4 disease may be best suited to RT/CRT. © 2016 Wiley Periodicals, Inc. Head Neck 38 : E2035–E2040, 2016