Does airway intervention before primary nonsurgical therapy for T3/T4 laryngeal squamous cell carcinoma impact on oncological or functional outcomes?

Publication

Does airway intervention before primary nonsurgical therapy for T3/T4 laryngeal squamous cell carcinoma impact on oncological or functional outcomes?

Journal Paper/Review - Nov 23, 2015

Schariatzadeh René, Pezier Thomas F, Studer Gabriela, Schmid Stephan, Huber Gerhard

Citation

Schariatzadeh R, Pezier T, Studer G, Schmid S, Huber G. Does airway intervention before primary nonsurgical therapy for T3/T4 laryngeal squamous cell carcinoma impact on oncological or functional outcomes?. Swiss Med Wkly 2015; 145:w14213.

Type

Journal Paper/Review (English)

Journal

Swiss Med Wkly 2015; 145

Publication Date

Nov 23, 2015

Issn Electronic

1424-3997

Pages

w14213

Brief description/objective

QUESTIONS UNDER STUDY
Even today, some patients with laryngeal cancer present with airway obstruction necessitating an intervention in the form of either a tracheostomy or transoral laser debulking (TOL). Controversy exists as to whether such an intervention is a risk factor for poor oncological or functional outcome in patients who then undergo primary (chemo)radiotherapy.

METHODS
Retrospective chart review of all patients undergoing primary curative nonsurgical treatment for T3/T4 laryngeal squamous cell cancer at the University Hospital Zurich between 1981 and 2011.

RESULTS
A total of 29/114 patients had an airway intervention before initiation of (chemo)radiotherapy (21/29 tracheostomies, 8/29 TOL). Kaplan-Meier analysis showed no statistical difference in oncological outcomes between the groups with and without intervention (5 year overall survival: 52% vs 70%, disease specific survival: 73% vs 79%, recurrence free survival: 53% vs 63%). In functional terms, we report an overall functional larynx rate of 60%.

CONCLUSIONS
Airway intervention was not found to be a risk factor for poor oncological or functional outcome in this patient group.