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Organ preservation vs primary surgery in the management of T3 laryngeal and hypopharyngeal cancers

  • Laryngology
  • Published:
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Abstract

Objective

The main objective is to compare the oncologic outcomes of patients with T3 laryngeal cancers who underwent total laryngectomy or organ preservation protocol (OPP) as the initial plan of management.

Materials and methods

This is a retrospective study on 120 patients treated for T3 laryngeal and hypopharyngeal cancers. Patients with functional larynx underwent OPP and dysfunctional larynx underwent upfront laryngectomy. Median follow-up of the patients was 4.6 years.

Results

There was a significant difference in 3 year disease-free survival (DFS) between upfront laryngectomy and OPP (73.2 vs. 55.7%; P = 0.028) group but not in 3 year overall survival (73.2 vs. 68.7%, P = 0.8). The rate laryngeal preservation was 65% in CCRT and 44% in only radiotherapy group. At 3 years, the laryngectomy-free survival was 57.2% and the laryngo-esophageal dysfunction-free survival (LEDS) was 53.0%.

Conclusion

T3 laryngeal cancers treated with upfront laryngectomy have an improved DFS when compared to those treated with non-surgical modalities. Primary surgery should be offered as an option for selected patients especially when CCRT is not feasible.

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Authors and Affiliations

  1. Head and Neck Surgical Oncology, Homi Bhabha National Institute, Tata Memorial Center, Room No. 1206, Homi Bhabha Block, Dr. E. Borges Road, Parel, Mumbai, 400012, India

    Sudhir Vasudevan Nair, Manish Mair, Noopur Sawarkar, Swagnik Chakrabarti, Burhanuddin Qayyumi, Deepa Nair & Pankaj Chaturvedi

  2. Radiation Oncology, Homi Bhabha National Institute, Tata Memorial Center, Mumbai, India

    Tejpal Gupta & Jai Prakash Agrawal

Authors
  1. Sudhir Vasudevan Nair
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  2. Manish Mair
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  3. Noopur Sawarkar
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  4. Swagnik Chakrabarti
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  5. Burhanuddin Qayyumi
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  6. Deepa Nair
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  8. Tejpal Gupta
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  9. Jai Prakash Agrawal
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Corresponding author

Correspondence to Sudhir Vasudevan Nair.

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Nair, S.V., Mair, M., Sawarkar, N. et al. Organ preservation vs primary surgery in the management of T3 laryngeal and hypopharyngeal cancers. Eur Arch Otorhinolaryngol 275, 2311–2316 (2018). https://doi.org/10.1007/s00405-018-5047-8

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  • DOI: https://doi.org/10.1007/s00405-018-5047-8

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