Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: Improved functional outcomes and survival with modern therapeutic approaches.

Abstract

BACKGROUND:

The purpose of this study was to evaluate the long-term outcomes after initial definitive or adjuvant radiotherapy (RT) for T3 laryngeal cancers.

METHODS:

We reviewed 412 patients treated for T3 laryngeal squamous cell cancer from 1985 to 2011.

RESULTS:

The 10-year overall survival (OS) was 35%; disease-specific-survival (DSS) was 61%; locoregional control was 76%; and freedom from distant metastasis was 83%. Chemotherapy, age, performance status <2, node-negative status, and glottic subsite were associated with improved survival (all p < .03). Larynx preservation with induction and/or concurrent chemoradiotherapy (LP-CRT) had better laryngectomy-free survival than RT alone (LP-RT; hazard ratio [HR] = 0.62; 95% confidence interval [CI] = 0.47-0.81; p = .0005); 10-year laryngectomy-free survival rates of the LP-CRT cohort (37%) were higher than those of the LP-RT cohort (18%). The 5-year DSS and OS rates of the LP-CRT cohort (79% and 67%) were better after total laryngectomy with postoperative RT (TL-PORT; 61% and 50%) and LP-RT (64% and 46%; p < .006 for all).

CONCLUSION:

In patients with T3 laryngeal cancers, LP-CRT provides better functional, oncologic, and survival outcomes than historical TL-PORT or LP-RT does. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1739-1751, 2016.

• Authors: Clifton D Fuller, Abdallah S R Mohamed, Adam S Garden, G Brandon Gunn, Collin F Mulcahy, Mark Zafereo, Jack Phan, Stephen Y Lai, Jan S Lewin, Katherine A Hutcheson, Steven J Frank, Beth M Beadle, William H Morrison, Adel K El-Naggar, Esengul Kocak-Uzel, Lawrence E Ginsberg, Merril S Kies, Randal S Weber, David I Rosenthal
• Journal: Head & neck (Head Neck) Vol. 38 Issue 12 Pg. 1739-1751 (12 2016) ISSN: 1097-0347 [Electronic] United States
• PMID: 27466789 (Publication Type: Journal Article)
• Copyright: © 2016 Wiley Periodicals, Inc.

Topics

• Adult
• Aged
• Analysis of Variance
• Cancer Care Facilities
• Carcinoma, Squamous Cell (mortality, pathology, therapy)
• Chemotherapy, Adjuvant
• Cohort Studies
• Disease-Free Survival
• Female
• Follow-Up Studies
• Head and Neck Neoplasms (mortality, pathology, therapy)
• Humans
• Kaplan-Meier Estimate
• Laryngeal Neoplasms (mortality, pathology, therapy)
• Laryngectomy (methods)
• Male
• Middle Aged
• Multivariate Analysis
• Neoadjuvant Therapy
• Neoplasm Invasiveness (pathology)
• Neoplasm Staging
• Proportional Hazards Models
• Radiotherapy, Adjuvant
• Retrospective Studies
• Squamous Cell Carcinoma of Head and Neck
• Survival Analysis
• Texas
• Treatment Outcome