Clinical outcomes in patients with T4 laryngeal cancer treated with primary radiotherapy versus primary laryngectomy

Head Neck. 2016 Apr:38 Suppl 1:E2035-40. doi: 10.1002/hed.24374. Epub 2016 Feb 1.

Abstract

Background: The purpose of this study was to determine the clinical outcomes of T4 laryngeal cancers.

Methods: T4 laryngeal cancers treated with curative intent from January 2003 to December 2010 were analyzed. Outcomes were evaluated in both primary radiotherapy (+/- chemotherapy) (RT/CRT) and primary surgery cohorts.

Results: Among the 65 primary RT/CRT and 42 primary surgery patients included, median follow-up was 4.4 years. There was a trend for improved locoregional control with surgery (74% vs 88%; p = .08). In the RT/CRT group the 3-year laryngectomy-free survival was 67%. The 2-year gastrostomy dependency rate was 23% with RT/CRT versus 6% with primary surgery (p = .07). Overall survival (OS) at 3 years was significantly lower in the RT/CRT versus primary surgery group (41% vs 70%; p < .01).

Conclusion: Laryngeal preservation is achieved in over two thirds of patients with primary RT/CRT. Patients with low volume minimal cartilage involvement T4 disease may be best suited to RT/CRT. © 2016 Wiley Periodicals, Inc. Head Neck 38: E2035-E2040, 2016.

Keywords: Dosimetric analysis; chemoradiotherapy; laryngeal carcinoma; laryngectomy; organ preservation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Laryngeal Neoplasms / diagnosis
  • Laryngeal Neoplasms / radiotherapy*
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome