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Laryngoscope ; 134(11): 4557-4563, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39152757

RESUMO

OBJECTIVES: The aim of this study was to document 10-year outcomes after supracricoid partial laryngectomy (SCPL) in selected cT3M0 laryngeal squamous cell carcinoma (SCC) patients. METHODS: This real-life retrospective observational study analyzed an inception cohort of 168 patients with isolated, untreated, selected cT3M0 laryngeal SCC, that were consecutively managed by SCPL during the period 1973-2013, and followed up until death or for a minimum of 10 years in 92% of cases at a single French academic and tertiary referral care center. Prior induction chemotherapy, arytenoid cartilage removal, level II-IV neck dissection, and postoperative radiation therapy were performed on 148, 77, 136, and 27 patients, respectively. The main objective was to determine 10-year actuarial local control and laryngeal preservation estimates. Secondary objectives included 10-year actuarial survival and cause-of-death analysis, and assessment of correlations between endpoints and clinical variables. The significance threshold was set at p < 0.005. RESULTS: Ten-year actuarial local control, laryngeal preservation, and survival estimates were 90%, 85%, and 52%, respectively. Salvage treatment resulted in an overall 99% local control rate. Metachronous second primary cancer, intercurrent disease without evidence of SCC, SCPL-related death, and uncontrolled local recurrence accounted for 31%, 26%, 7%, and 2% of causes of death. On univariate analysis, overall local recurrence and laryngeal preservation rates varied significantly, from 5% to 54% and 90% to 46% when resection margins were R0 and R1, respectively. CONCLUSION: The present study highlighted successful 10-year outcomes after SCPL, providing further evidence in favor of its integration into the conservative armamentarium for endolaryngeal cT3 SCC. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:4557-4563, 2024.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Laríngeas , Laringectomia , Estadiamento de Neoplasias , Humanos , Neoplasias Laríngeas/cirurgia , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/mortalidade , Laringectomia/métodos , Estudos Retrospectivos , Masculino , Pessoa de Meia-Idade , Feminino , Idoso , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/mortalidade , Resultado do Tratamento , Cartilagem Cricoide/cirurgia , Adulto , Idoso de 80 Anos ou mais , Taxa de Sobrevida , Terapia de Salvação/métodos , Recidiva Local de Neoplasia/epidemiologia , Seguimentos
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