Premium
Primary organ preservation vs total laryngectomy for T4a larynx cancer
Author(s) -
Oh Justin,
Prisman Eitan,
Olson Robert,
Berthelet Eric,
Wu Jonn,
Tran Eric,
Bakos Brendan,
Kaviani Rojin,
Hamilton Sarah Nicole
Publication year - 2019
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.25838
Subject(s) - laryngectomy , medicine , larynx , chemoradiotherapy , radiation therapy , cancer , confidence interval , surgery
Background There is a lack of consensus regarding the management of T4a larynx cancer. We evaluated the outcomes of organ preservation and laryngectomy for T4a laryngeal cancer. Methods Retrospective analysis of patients with T4a larynx cancer at BC Cancer from 1984 to 2014 was performed. Outcomes in patients treated with surgery alone (Sx) (n = 47), surgery with adjuvant radiotherapy (Sx/RT) (n = 94), radiation alone (RT) (n = 152), and radiation with concurrent chemoradiotherapy (chemoRT) (n = 36) were compared. Results The 5‐year overall survival (OS) was 40% for chemoRT, 34% for RT, 23% for Sx, and 45% for Sx/RT. On multivariate analysis (MVA), Sx/RT (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.48‐0.91) and chemoRT (HR, 0.44; 95% CI, 0.26‐0.72) were associated with better OS than RT alone ( P = .001). Sx had similar OS compared to RT (HR, 1.17; 95% CI, 0.82‐1.68). Conclusions ChemoRT and Sx/RT were associated with better OS compared to single modality treatment. ChemoRT may be considered as an option for T4a larynx cancer.