Laryngeal conservative surgery in patients candidates for combined treatment with chemo-radiotherapy
| Autor: | Alma Lilia Ortiz-Maldonado, Iván Cruz-Esquivel, Pablo Pichardo-Romero, Héctor Arias-Ceballos, Gerardo Gabriel Minauro-Muñoz, José Francisco Gallegos-Hernández |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Partial laryngectomy medicine.medical_specialty Laringectomía conservadora medicine.medical_treatment Laryngectomy Conservative laryngectomy Ocean Engineering Cirugía conservadora 03 medical and health sciences 0302 clinical medicine Tracheotomy Swallowing Laryngeal cancer medicine Humans Combined Modality Therapy 030223 otorhinolaryngology Laryngeal Neoplasms Aged Retrospective Studies Aged 80 and over business.industry Cáncer de laringe Conservative surgery Supracricoid Laryngectomy Retrospective cohort study Laringectomía parcial Middle Aged Laryngeal Neoplasm Gastrostomy Surgery Cross-Sectional Studies 030220 oncology & carcinogenesis Female business Organ Sparing Treatments |
| Zdroj: | Cirugía y Cirujanos (English Edition). 84:96-101 |
| ISSN: | 2444-0507 |
| DOI: | 10.1016/j.circen.2016.02.006 |
| Popis: | Background The standard of care for advanced-stage laryngeal cancer is combined treatment (chemo-radiotherapy). However, the complications with this treatment are not few, mainly in swallowing. Conservative laryngeal surgery remains an effective alternative for cancer control without the complications of chemo-radiotherapy. Material and methods Retrospective study was conducted on patients with laryngeal cancer cT3, cN0 with paraglottic infiltration, fixation of the vocal cord, minimal invasion of the hyo-thyroepiglottic space, but with normal arytenoid mobility and no sub-glottic extension, were treated with subtotal supracricoid laryngectomy. Complications, sequels of treatment, and local recurrence were evaluated. Bronchial aspiration was studied with radioactive swallow. Results There were 25 patients, 22 with negative surgical margins, one had tumour contact with the surgical margins, and 2 were positive. Two patients received postoperative radiotherapy. The mean decannulation was 15 days and removal of nasogastric tube 25 days. During the mean follow-up of 26 months, none of the patients had tumour recurrence or required conversion to total laryngectomy. In all patients swallowing has been normal and none required permanent or temporary tracheotomy or definitive gastrostomy. The voice is considered intelligible in all patients. Radioactive swallow showed aspiration in 15/25 patients, with none being clinically relevant. There were postoperative complications in 5 patients, and 4 patients required re-intervention but no conversion to total laryngectomy. Conclusion Conservative surgery is an effective surgical-alternative to chemo-radiotherapy in patients with locally advanced laryngeal cancer, providing oncological control, acceptable complications and minimal sequels. Although most patients have aspiration, this does not affect functional status. |
| Databáze: | OpenAIRE |
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