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  • Title: Analysis of clinicopathological stage in supracricoid partial laryngectomy patients: Need for adjuvant therapy in clinically understaged cases.
    Author: Cho KJ, Sun DI, Joo YH, Kim MS.
    Journal: Auris Nasus Larynx; 2011 Apr; 38(2):255-60. PubMed ID: 20727697.
    Abstract:
    OBJECTIVE: The aim of this study is to evaluate the impact of pre-operative T-understaging on clinical outcome in supracricoid partial laryngectomy (SCPL). METHODS: The medical records of 92 patients who underwent SCPL were evaluated. By comparing clinical and pathologic stages, the causes of pre-operative T-understaging and its relationship with local recurrence and survival were examined. RESULTS: Fifteen patients (16.3%) were found to be underestimated in terms of pre-operative T-stage, primarily due to failure to identify thyroid cartilage invasion (11 cases). Among these, radiation treatment at the primary site was offered in only two cases, including one case with a positive surgical margin. Among 82 patients followed for over 1 year, local recurrence occurred in seven patients (8.5%); five of these (71.4%) had been understaged pre-operatively due to failure to detect thyroid cartilage invasion. The local recurrence rate was higher and the overall survival rate was lower in patients who were understaged pre-operatively, compared to those who were staged accurately (p=0.006 and p=0.001, respectively). CONCLUSION: SCPL should be conducted only after a thorough pre-operative evaluation in locally advanced laryngeal cancer. Additionally, adjuvant treatment is necessary to reduce local recurrence in cases where thyroid cartilage invasion is determined pathologically after SCPL.
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