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• W2896595564 abstract "Selecting the right treatment for locally advanced laryngeal cancer is challenging. It can be treated with total laryngectomy (TL) or larynx-preservation (LP). TL is recommended for more advanced (T4) disease, whereas LP is usually reserved for T3 disease. We hypothesize that patients with T3 disease, despite having larynx preservation (T3-LP), have a better clinical outcome compared to those with T4 disease treated with TL (T4-TL). A retrospective analysis was conducted on patients with T3 and T4 laryngeal cancer, treated at our institution between January 2007 and July 2015. Patients with history of other malignancies within 3 years of laryngeal cancer diagnosis, metastatic disease at diagnosis and/or intent of palliative treatment were excluded. All patients who received radiotherapy were treated with intensity modulated radiotherapy (IMRT); Tomotherapy is used at our centre. Demographics, tumor and treatment factors were collected and clinical outcomes, including overall survival (OS), salvage laryngectomy-free survival (LFS), and failure free survival (FFS), were analyzed. A total of 103 patients were eligible for analysis. Median age at diagnosis was 64 years (range: 37-93 years). Median follow-up was 36 months (range: 1-123 months) and 53 months for the patients alive at last follow up. Among all patients, 68% had clinical T3 disease, among which 83% underwent LP, while 32% of patients had T4 disease, among which 70% underwent TL. N0 disease was found in 59% of patients, while 41% had N+ disease. Out of 58 T3-LP patients, 31% had salvage laryngectomy at median 11 months after diagnosis. No statistically significant difference was observed between T3-LP and T4-TL groups in 3-year OS (66% versus 64%, respectively, p = 0.5) or 5-year OS (57% versus 47%, respectively, p = 0.5). Three-year FFS was 52% in T3-LP group versus 75% in T4-TL group (p = 0.07). The findings were as a result of higher loco-regional failure rate in T3-LP group compared to T4-TL group (RR = 5.53, 95% CI: 1-15.6, p = 0.025). Three-year LFS was 68% in T3-LP group. In the era of IMRT, about two thirds of patients with T3 disease treated with larynx preservation at our centre continue to have an intact larynx 3 years after their diagnosis. Although these patients have higher loco-regional failure rate, they can be salvaged and have similar survival outcomes compared to patients with T4 disease treated with total laryngectomy. Therefore, larynx preservation remains a suitable option for patients with T3 laryngeal cancer." @default.
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• W2896595564 date "2018-11-01" @default.
• W2896595564 modified "2023-09-27" @default.
• W2896595564 title "Evaluation of Larynx Preservation on Patients with Locally Advanced Laryngeal Cancer in the Era of IMRT: Results from a Single Tertiary Cancer Center" @default.
• W2896595564 doi "https://doi.org/10.1016/j.ijrobp.2018.07.789" @default.
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