Management Of Laryngeal Carcinoma Research Articles

One hundred fifty years of total laryngectomies.

The inaugural total laryngectomy in history was conducted by Billroth in 1873. Nevertheless, significant enhancements to the technique were achieved through the contributions of Gluck, Sorensen, and various other surgeons. Throughout the twentieth century, advancements in anesthesia, infectious disease, hospital hygiene, antibiotic therapy, resuscitation, and the expertise of numerous laryngologists elevated total laryngectomy to a pivotal surgical intervention in head and neck surgery. The latter half of the twentieth century witnessed a paradigm shift with the emergence of organ preservation protocols. Total laryngectomy became the preferred choice for patients experiencing radiotherapy failure. However, the widespread use of laryngeal conservative treatments appears to be correlated with a decline in overall survival rates in the United States and Europe. The evolution of new minimally invasive surgical approaches in the twenty-first century may usher in a revolutionary era in the management of laryngeal carcinoma, offering the potential for improved survival and functional outcomes.

Clinical study of carcinoma of larynx: a retrospective analysis

<p><strong>Background:</strong> Carcinoma of larynx is the third most common cancer in head and neck, sixth most common cancer among men in India. This study aims to identify the patterns of clinical presentation, epidemiological features and management of laryngeal carcinoma in a tertiary care centre of Indian armed forces.</p><p><strong>Methods</strong>: This is a retrospective analysis of patients admitted in a Command hospital from January 2007 to December 2009.</p><p><strong>Results</strong>: A total of 28 patients were treated in 3 year duration. All the patients were males. The majority of patients belonged to 7<sup>th</sup> decade of life with youngest 49 years old and the oldest 80 years. Supraglottic carcinoma (71%) was the most common laryngeal carcinoma followed by glottic carcinoma(29%).Hoarseness of voice (82%) was the most common presenting complaint followed by dysphagia (42%) and dysponea (21%). 32% of patients reported after initial emergency tracheostomy. 12 (42%) patients were treated with curative surgery, 4 (14%) were treated with curative radiotherapy. Rest of patients required palliative therapy.</p><p><strong>Conclusions:</strong> Laryngeal carcinoma is found predominantly in males at seventh decade of life and advanced stage. Treatment with curative intent may be possible in around 70% of patients<strong>.</strong></p>

Quality Of Life of Laryngeal Carcinoma Patients after Total Laryngectomy

Background : Management of laryngeal carcinoma has been widely developed, either by surgery, radiotherapy, and/or chemotherapy. The treatment has a major impact on physical, social, and psychological health that can change the quality of life of patients. This study aimed to determine the quality of life of laryngeal carcinoma patients after total laryngectomy. Methods : This descriptive study was conducted from May to August 2018. Patients with post total laryngectomy at the Division of Ear, Nose, Throat, Head and Neck Surgery, Dr. Hasan Sadikin General Hospital, Bandung were recruited. Short Form 36 (SF-36) Study Questionnaire and the European Organization for Research and Treatment of Cancer Head and Neck Cancer Quality of Life Questionnaire (EORTC QLQ-H & N35) were used, and data were presented in the form of descriptive narratives and tables. Results : In total, 23 patients were included consisting of 19 men (82.61%) and women (17.39%), aged 56-65 years old. The mean score of quality of life in physical components of SF-36 was 87.55 ± 2.35 and in mental components was 85.35 ± 3.92. The highest score of quality of life of EORTC QLQ-H & N35 on the speech problem scale was 51.69 ± 6.36. Conclusion : The quality of life of laryngeal carcinoma patients after total laryngectomy is generally good, however, speech is the main problem and needs to be further elaborated to enhance the quality of life.

The role of sentinel lymph node biopsy in the management of laryngeal carcinoma.

The role of sentinel lymph node biopsy in the management of laryngeal carcinoma.

Management of patients with cancer of the larynx in Suez Canal University Teaching Hospital: 5 years’ experience

Abstract Suez Canal University Hospital, which is the only tertiary care facility in the Suez Canal and Sinai area, is estimated to service more than 5 million patients. Cancer of the larynx, which is the most common head and neck cancer, is also the most common tumor presented to the otolaryngology departments. To evaluate the results of interventional protocols for patients with cancer of the larynx treated in Suez Canal University Hospital. This was a retrospective study carried out on 53 patients with cancer of the larynx reviewed from 1 January 2007 to 1 January 2012 according to demographic, clinical, radiological, operative, pathological data, and possible complications. Fifty-three patients, mean age 58 years (71.1% were from urban areas), were studied. The main presenting symptom was hoarseness of voice (66%). Glottis carcinoma was the most common type of cancer found in 41.1% patients. Stage IVa was the most common presenting stage in 39.6% of the patients. Emergent tracheostomy was performed for 39.6% of the patients. According to the treatment protocol, single treatment modality was recommended for 38 (71.6%) patients: 17 (32%) patients were recommended total laryngectomy, followed by radiotherapy in 11 (20.7%) patients, chemotherapy was recommended for eight (15.1%) patients, concurrent chemoradiotherapy was offered to one (1.9%) patient, and partial laryngectomy with preservation of both arytenoids was offered to one (1.9%) patient. In addition, 15 (28.4%) patients were subjected to combined therapy: total laryngectomy combined with radiotherapy in nine (17%) patients and total laryngectomy with chemoradiotherapy in six (11.4%) patients. Although the standards of management of laryngeal carcinoma in Suez Canal University hospital are almost in compliance with regional and international standards, we need to deal with the time delay between the diagnosis and definitive treatment to revise the items in the medical records and its registration.

Supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP) in the management of laryngeal carcinoma: oncologic results. A 35-year experience

To evaluate the long-term oncologic results of supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP) for laryngeal cancer. A 35-year retrospective study concerning 291 patients treated by supracricoid laryngectomy with CHEP for laryngeal cancer was performed. The following postoperative data were studied: recurrence rates (lymph node and laryngeal), distant metastases and second cancer. The mortality rate and overall survival were estimated by the Kaplan-Meier method. The postoperative mortality was 1.03 %. 23 patients were lost to follow-up. The 3-year survival rate was 84 % and the 5-year survival rate was 80 %. 12 patients developed distant metastasis. 31 patients developed a second cancer. The local (laryngeal) control rate was 93.94 % and the regional (cervical lymph node) control rate was 92.05 %. In multivariate analysis, the occurrence of a second non-ENT cancer and metastasis as well as margins involvement were reliable to mortality. Supracricoid laryngectomy with CHEP appears to be associated with very good long-term oncologic results and still has a place in the management of T1, T2 and selected T3 glottic cancers.

Outcome of surgical management of laryngeal carcinoma: a 5-year experience

ObjectiveTo investigate the outcome of surgically managed laryngeal carcinoma patients attending an outpatient clinic over a 5-year period.Material and MethodsThis was an analytical, retrospective, cross-sectional study. A total of 36 laryngeal carcinoma patients who were managed surgically with or without radiotherapy were analyzed.ResultsA total of 32 patients (89%) were found to be disease-free during follow-up for up to 5 years. Two patients (5.5%) died because of intercurrent infection and recurrence of the disease and two (5.5%) were lost to follow-up 5 and 7 months after surgery, respectively.ConclusionsThe results indicate that the best disease-free rates can be achieved by managing laryngeal carcinoma surgically with or without radiotherapy depending on the advancement and aggressiveness of the disease.

Supracricoid partial laryngectomy with cricohyoidopexy in the management of laryngeal carcinoma.

Supracricoid partial laryngectomy with cricohyoidopexy is a conservative laryngeal procedure indicated in selected cases of supraglottic and transglottic carcinoma. In this technique, the thyroid cartilage, the paraglottic space, the preepiglottic space, and the whole epiglottis are excised, whereas the hyoid bone, the cricoid cartilage, and one or two artenoid cartilages are preserved. A cricohyoidopexy is used for closure. The surgical principle is based on the preservation of at least one functional and mobile cricoarytenoid unit. This procedure is a true organ preservation technique, as it preserves physiological rehabilitation of speech, swallowing, and respiration without a permanent tracheostomy. Indications, contraindications surgical technique, postoperative care, complications, and functional and oncological results are presented and discussed.

784 Poster The prognostic importance of multidisciplinary approach in the management of laryngeal carcinoma

784 Poster The prognostic importance of multidisciplinary approach in the management of laryngeal carcinoma

Stomal recurrence after total laryngectomy for squamous cell carcinoma of the larynx

Objective: Stomal recurrence after total laryngectomy is one of the most serious issues in the management of laryngeal carcinoma. The management of stomal recurrence, including chemotherapy, radiotherapy, and surgery, has been reported as unsatisfactory. Study Design and Setting: From 1985 to 1995, 69 patients underwent total laryngectomy for the treatment of laryngeal cancer at the University of Tokyo Hospital. To identify the risk factors for stomal recurrence, we analyzed these patients according to various clinicopathological factors. Results: Stomal recurrence developed in 6 of 69 patients who underwent total laryngectomy for laryngeal carcinoma. Statistical analysis reveals that primary site, preoperative tracheotomy, and paratracheal lymph node metastasis are significant risk factors for stomal recurrence. Conclusion: Intensive follow-up should be performed for patients with glottic carcinoma who had preoperative tracheotomy, paratracheal lymph node metastasis, or both to detect stomal recurrence at an early stage. (Otolaryngol Head Neck Surg 2002;126:63-6.)

Tracheostomy and radiotherapy in the management of laryngeal carcinoma causing airway obstruction

Between 1977 and 1985, 66 patients presenting with airway obstruction due to laryngeal squamous cell carcinoma were treated by tracheostomy and subsequent radiotherapy. Female survival (64% at 2 years and 35% at 5 years) was significantly better than male survival (19% at 2 years and 10% at 5 years). When four forms of management were compared, it appeared that 40 Gy in ten fractions over 21 days was associated with better survival. Because two of the treatment groups contained few patients, these were excluded from further analysis. When adjustments were made for sex, delay between tracheostomy and treatment, and residual disease, the difference in treatment response between those receiving 60+ Gy in 28–30 fractions over 42 days and those receiving 40 Gy in ten fractions over 21 days was not significant (hazard ratio 1.37; 95% CI 0.64–3.91).

Osteoradionecrosis of the Hyoid Induced by Combined Modality Therapy for Laryngeal Carcinoma

Contemporary management of laryngeal carcinoma often incorporates multiple modalities of therapy. We report a case of osteoradionecrosis of the hyoid bone in a patient treated with surgery, chemotherapy, and radiation therapy for a supraglottic squamous cell carcinoma. A discussion regarding pathophysiology, radiation dosimetry and treatment options is also presented.

Laryngeal conservation surgery

T he management of laryngeal carcinoma by conservation surgery is one of the most challenging aspects of head and neck surgical oncology, because both surgical expertise and a thorough understanding of the disease process are required for a successful outcome. Improper patient selection or an error in surgical judgment can result in lifethreatening complications or tumor recurrence in a patient with potentially curable disease. In the United States, laryngeal cancer (including pyriform fossa) afflicts 12,300 patients per year, representing 1.2% of all cancers and 50% of head and neck malignancies.’ Less than half of these patients develop early-stage lesions (Tl or T2), which are amenable to conservation surgery. Therefore, only 4,000 to 5,000 patients a year are candidates for conservation treatment. Many patients with earlystage lesions can be successfully treated with radiotherapy, leaving only a limited number of patients who require surgical therapy. However, this low number of candidates for surgical therapy results in fewer opportunities for training surgeons in these techniques and for maintaining the skills of established head and neck surgeons. Although the most important treatment goal is to cure the patient, quality-of-life issues are more than ever assuming an even greater role in the treatment decision-making process. Critical factors in evaluating treatment outcome are voice quality, deglutition, and complications of treatment such as aspiration, dysphagia, and radiation necrosis. Many times the decision to operate or irradiate depends on the treating physician’s personal philosophy. The purpose of this article is not to extol the virtue of any one modality over the other, but rather to help the treating physician identify the patient who may best be treated with conservation surgery with or without postoperative radiotherapy.

The role of radiotherapy in the management of laryngeal carcinoma

The role of radiotherapy in the management of laryngeal carcinoma

Preoperative irradiation in laryngeal carcinoma.

THE ROLE of preoperative irradiation in the management of laryngeal carcinoma is one of the most promising and yet debatable subjects before us at the present time. We find ourselves in the dilemma of attempting to decide when to intelligently use such therapy, at a time when reports of sufficiently large, and controlled series of patients treated by this form of therapy are unavailable. Accordingly, it would seem desirable, to survey the recent literature regarding this form of therapy as it pertains to carcinoma of the larynx specifically and head and neck surgery in general. On the surface, it would seem that the use of combined irradiation and surgery would be advantageous by the simple principle that two modalities of treatment would be better than one. Unfortunately, it is not nearly this simple. Numerous factors must be considered in prognosticating whether, in individual cases, the combination of irradiation and surgery