Comparison of total laryngectomy with surgical (cricohyoidopexy) and nonsurgical organ-preservation modalities in advanced laryngeal squamous cell carcinomas: A multicenter retrospective analysis

Head Neck. 2013 Apr;35(4):554-61. doi: 10.1002/hed.22994. Epub 2012 Apr 12.

Abstract

Background: Functional outcome and quality of life (QOL) have become relevant endpoints in the field of laryngeal oncology, leading to the emergence of organ-preserving strategies.

Methods: The medical records of 166 patients with advanced (stages III and IV) laryngeal squamous cell carcinoma (SCC) who were treated with a total laryngectomy, radiochemotherapy, or cricohyoidopexy (CHP) were reviewed.

Results: In the whole series, no statistically significant differences among the 3 treatment arms with respect to the overall survival (OS) and disease-specific survival (DSS) rates were observed. The organ-preservation rate was 45% for radiotherapy and 76.7% for CHP (p = .0002). Among the cT4a cases, a longer survival was observed for the patients treated with total laryngectomy (3 yr-OS = 78% vs 68% for CHP and 54% for radiochemotherapy, p = .031).

Conclusions: In advanced laryngeal SCC, CHP shows survival rates comparable to those of radiochemotherapy and a higher larynx-preservation rate, although it may not replace radiochemotherapy because it can be recommended only in selected cases.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / surgery*
  • Carcinoma, Squamous Cell / therapy
  • Chemoradiotherapy
  • Combined Modality Therapy
  • Cricoid Cartilage / pathology*
  • Cricoid Cartilage / surgery
  • Female
  • Head and Neck Neoplasms / surgery*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Laryngeal Neoplasms / surgery*
  • Laryngeal Neoplasms / therapy
  • Laryngectomy / methods*
  • Larynx / pathology*
  • Larynx / surgery
  • Male
  • Middle Aged
  • Quality of Life
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Rate
  • Treatment Outcome