Treatment of Laryngeal Cancer: Rationale and Outcomes

Abstract

Objective: 1) Evaluate the rationale for choice of treatment modality in patients with laryngeal cancer. 2) Compare outcomes among various treatment modalities for patients with laryngeal cancer. Method: A retrospective review was conducted of patients treated for laryngeal cancer between 2006 and 2011. Data were recorded on treatment modality and rationale (radiation therapy (RT), transoral laser microsurgery (TLM), open partial laryngectomy (PL), or total laryngectomy (TL)), and oncologic/functional outcomes. Statistics included chi-square and bonferroni tests. Results: Seventy-nine patients were identified (18 RT, 19 TLM, 20 PL, and 22 TL). TLM was primarily used for early-stage disease, RT and PL for all disease stages, and TL for advanced disease. RT and TL were usually chosen due to tumor extension or patient health precluding conservation surgery. No surgical patients, but 28% of RT patients required permanent tracheostomy. Voice quality was similar for RT and TLM patients, while PL was significantly worse. All TLM patients resumed a normal diet; a small percentage of RT (17%), PL (10%), and TL (18%) patients required permanent feeding tube use. Conclusion: Multiple treatment modalities for laryngeal cancer exist, and treatment decisions are usually driven by a combination of tumor characteristics, patient health, and patient preferences. Future research may better define the relative merits of the various treatment strategies available.