The American Society of Clinical Oncology has released new guideline recommendations for the use of larynx-preservation strategies in the treatment of laryngeal cancer, which was published
in the Journal of Clinical Oncology.
A panel of expert confirmed that the use of a
larynx-preservation approach for patients does not compromise survival.
Furthermore, there was no larynx-preservation strategy found that offered a
survival advantage compared with total laryngectomy and adjuvant therapy. Changes
to the previous recommendations involved the use of endoscopic surgical
resection in patients with T1 and T2 disease, initial total laryngectomy in
patients with T4a disease, and PET imaging for evaluating regional nodes.
According to the new recommendations,
patients with T1 or T2 laryngeal cancer should begin treatment with intent to
preserve the larynx by using endoscopic resection or radiation therapy. As for
patients with T2 or T4 disease, organ-preserving surgery in combination with
chemotherapy and radiation (or radiation alone) may preserve the larynx without
compromising overall survival. Selected patients with extensive T3 or large T4a
lesions or poor laryngeal function prior to treatment are recommended total laryngectomy
to achieve better survival rates and quality of life.
