Patel et al. from Boston University
School of Medicine, analyzed the National Cancer Data Base between 2003 and 2011 (published in Cancer,June 2019) comparing surgical and nonsurgical larynx-preserving treatments with
total laryngectomy for locally advanced laryngeal cancer.
They identified 8703 patients with stage
III/IV (excluding T1 tumors) laryngeal squamous cell carcinoma treated with
chemoradiation (CRT) or partial laryngectomy (PL) and total
laryngectomy(TL) with or without
adjuvant therapy.
The authors found that:
- Among patients with non-T4, low nodal burden (T2N1 or T3N0-N1) disease, no survival differences were observed between CRT, PL, and TL.
- Patients who had non-T4, high nodal burden (T2-T3N2-N3) disease who underwent TL with or without adjuvant treatment had a higher risk of death compared with those who received CRT.
- No statistically significant difference in outcome was noted between CRT and PL for all stage groups.
The authors concluded that patients with
non-T4, high nodal burden disease may benefit from definitive CRT. Total
laryngectomy remains advantageous in patients with T4 disease.
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