Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments
| Autor: | Joan Berenguer, Isabel Vilaseca, Eduardo Lehrer, Paola Castillo, Manuel Bernal-Sprekelsen, Marta Jordana, Neus Baste, Juan J. Grau, Africa Muxi, I. Valduvieco, José Miguel Costa, Rosa Delia Ramírez-Ruiz, Laura Oleaga, Francesc Xavier Avilés-Jurado |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Larynx
medicine.medical_specialty Glottis Microsurgery Cord Cancer cells medicine.medical_treatment Locally advanced Urology Laryngectomy Disease-Free Survival Càncer de laringe medicine Positive Margins Humans Transoral laser microsurgery Laryngeal Neoplasms Neoplasm Staging Retrospective Studies business.industry Hazard ratio Teixit connectiu Cancer Larynx cancer medicine.disease Prognosis Neck cancer Lasers in surgery Càncer de coll medicine.anatomical_structure Cartilage Otorhinolaryngology Microcirurgia Cèl·lules canceroses Laser Therapy Cartílag Connective tissue business Làsers en cirurgia |
| Popis: | To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery. Background: To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery. Methods: Two hundred and two consecutive pT3-T4a larynx carcinomas. Pre-epiglottic space involvement, anterior and posterior paraglottic space (PGS) involvement, vocal cord, and arytenoid mobility were determined. Local control with laser (LC), overall survival (OS), disease-specific survival (DSS), and laryngectomy-free survival (LFS) were evaluated. Results: The lowest LC was found in tumors with fixed arytenoid. In the multivariate analysis, positive margins (hazard ratio [HR] = 0.289 [0.085-0.979]) and anterior (HR = 0.278 [0.128-0.605]) and posterior (HR = 0.269 [0.115-0.630]) PGS invasion were independent factors of a reduced LC. Anterior (HR = 3.613 [1.537-8.495]) and posterior (HR = 5.195 [2.167-12.455]) PGS involvement were independent factors of total laryngectomy. Five-year OS, DSS, and LFS rates were 63.9%, 77.5%, and 77.5%, respectively. Patients with posterior PGS presented a reduced 5-year LFS. Conclusions: Tumor classification according to laryngeal compartmentalization depicts strong correlation with LC and LFS. |
| Databáze: | OpenAIRE |
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