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  • Title: Local control after supracricoid partial laryngectomy for "advanced" endolaryngeal squamous cell carcinoma classified as T3.
    Author: Dufour X, Hans S, De Mones E, Brasnu D, Ménard M, Laccourreye O.
    Journal: Arch Otolaryngol Head Neck Surg; 2004 Sep; 130(9):1092-9. PubMed ID: 15381597.
    Abstract:
    OBJECTIVES: To determine the incidence of local control in patients with "advanced" moderately to well-differentiated endolaryngeal invasive squamous cell carcinoma classified as T3, treated with a supracricoid partial laryngectomy; to identify any statistical relationship; and to analyze the consequences of local recurrence. DESIGN: Retrospective nonrandomized case series. SETTING: A tertiary referral care center and university teaching hospital. PATIENTS: An inception cohort of 118 patients. Tumor stage was T3 N0 M0 in 90 patients, T3 N1 M0 in 21 patients, T3 N2 M0 in 5 patients, and T3 N3 M0 in 2 patients. INTERVENTIONS: All patients underwent supracricoid partial laryngectomy. A platin-based induction chemotherapy regimen was used in 100 patients. Postoperative radiotherapy was used for 24 patients. MAIN OUTCOME MEASURES: Local recurrence, nodal recurrence, distant metastasis, and survival; univariate and multivariate analysis of local recurrence. RESULTS: Nine patients developed a local recurrence. The 1-, 3-, and 5-year actuarial local control estimates were 97.3%, 93.5%, and 91.4%, respectively. In a stepwise regression model, the presence of positive margins of resection was the only variable that statistically increased the risk of local recurrence (P =.008). Local recurrence resulted in a significant increase in nodal recurrence (P<.001) and distant metastasis (P<.001) and a significant decrease in survival (P =.03). An overall 89.8% laryngeal preservation rate and 98.3% local control rate were achieved. CONCLUSION: Supracricoid partial laryngectomies should be considered when an organ preservation strategy is discussed in patients with advanced endolaryngeal squamous cell carcinoma classified as T3.
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