Organ preservation for advanced laryngeal carcinoma

Head Neck. 2006 Aug;28(8):689-96. doi: 10.1002/hed.20387.

Abstract

Background: Inclusion of patients with mobile vocal cords on larynx preservation trials may lead to overstatement of larynx preservation (LPR) and survival (OS) rates.

Methods: This is a retrospective review of patients at our institution who would have been eligible for the Department of Veterans Affairs Laryngeal Cancer Study Group (VA) and Radiation Therapy Oncology Group/Head and Neck Intergroup (RTOG 91-11) clinical trials. No laryngeal conservation procedure could be performed in patients with mobile vocal cords.

Results: One hundred one patients at our institution would have been eligible for the VA trial. The 2-year OS was 76% for total laryngectomy and 90% for radiotherapy patients (p = .28) compared with 68% reported for the VA trial. Seventy-three patients at our institution would have been eligible for the RTOG 91-11 trial. The 5-year OS was 52% for total laryngectomy and 63% for radiotherapy patients (p = .18) compared with 55% reported for the RTOG 91-11 trial. Radiotherapy patients had an LPR of 80% (VA trial) and 86% (RTOG 91-11 trial).

Conclusion: It is unlikely that inclusion of patients with mobile vocal cords had a significant impact on OS or LPR for the VA and RTOG 91-11 larynx preservation trials.

MeSH terms

  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Female
  • Humans
  • Karnofsky Performance Status
  • Laryngeal Neoplasms / drug therapy
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / radiotherapy
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy*
  • Larynx / surgery*
  • Male
  • Middle Aged
  • Radiotherapy Dosage
  • Radiotherapy, Adjuvant
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome