The management of advanced laryngeal and hypopharyngeal cancers between years 20202021 single-centre experience

Abstract

Introduction: Laryngeal cancer is the most frequent neoplasm of the head and neck region. Despite advances in chemo-radiotherapy (CRT), surgery still remains an important role in the management of laryngeal cancer. Laryngeal preservation techniques, including endoscopic laser resection, are becoming more popular nowadays. However, total laryngectomy (TL) remains a reasonable option for advanced disease in selected patients. The main aim of this study was to perform general characteristics of patients with advanced laryngeal and hypopharyngeal cancer treated with TL as well as to perform a detailed analysis of the disease, treatment modalities and complications. Material and methods: This is a retrospective single-centre analysis. Baseline characteristics and preoperative clinical variables were collected. The study group consisted of 42 patients with advanced-stage carcinoma of the larynx and hypopharynx treated with TL between January 2020 and December 2021 at the Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Warsaw, Poland. Preoperative and postoperative clinical variables were collected. Statistical analysis was performed using R software (R version 4.0.3). Results: The mean age of patients at diagnosis was 63.6 +/- 9.2 years, 32 (76.2%) patients were male. The most common symptoms at diagnosis were: hoarseness (78.6%) and dyspnea (47.6%). There was no statistically significant association between symptoms present at diagnosis and the stage of diagnosed laryngeal cancer according to the TNM classification (T3, T4a, T4b). Stage III was observed in 33 (78.6%) patients, IVa in 8 (19%) and IVb in 1 (2.4%) patient. Of the 42 included patients, total laryngectomy was performed in 39 (92.9%) patients and pharyngolaryngectomy in 3 (7.1%) patients. Tracheoesophageal voice prosthesis was implanted in all patients. Complications after surgery were observed in 5 (11.9%) patients. Squamous cell carcinoma was diagnosed in 100% of patients. Complementary therapy was performed in 36 (85.7%) patients. Conclusions: Our study population confirmed that patients suffering from advanced laryngeal and hypopharyngeal cancer are mostly men aged over 60 years with the most common variant of smoking history of over 20 cigarettes per day for a period over 5 years. Symptoms at diagnosis and TNM classification staging of laryngeal cancer are not related parameters.