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Outcomes of mini-invasive transoral surgery without neck dissection in supraglottic laryngeal cancer: Real world data from a tertiary cancer center.
Zorzi, Stefano; Pietrobon, Giacomo; Mossinelli, Chiara; Bandi, Francesco; Chu, Francesco; Tagliabue, Marta; De Berardinis, Rita; Zocchi, Jacopo; Alterio, Daniela; Rocca, Maria Cossu; Ruju, Francesca; Ansarin, Mohssen.
Affiliation
  • Zorzi S; Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
  • Pietrobon G; Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
  • Mossinelli C; Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy. Electronic address: chiara.mossinelli@ieo.it.
  • Bandi F; Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
  • Chu F; Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
  • Tagliabue M; Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy; Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
  • De Berardinis R; Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
  • Zocchi J; Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
  • Alterio D; Division of Radiation Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
  • Rocca MC; Division of Medical Oncology, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
  • Ruju F; Division of Radiology, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
  • Ansarin M; Department of Otorhinolaryngology and Head and Neck Surgery, IEO, European Institute of Oncology, IRCCS, Milan, Italy.
Am J Otolaryngol ; 45(1): 104113, 2024.
Article in En | MEDLINE | ID: mdl-37956498
ABSTRACT

PURPOSE:

The neck management in early-stage cN0 supraglottic cancer represents an argument of debate. The aim of our study is to evaluate the oncological and functional outcomes in patients with early-stage cN0 supraglottic carcinoma treated with a wait-and-see policy for the neck. MATERIALS AND

METHODS:

Retrospective monocentric cohort study in a referral cancer care center. We collected a consecutive sample of patients from 2000 to 2020 with Squamous Cell Carcinoma of the supraglottis without clinical evidence of nodal metastases (cN0), surgically treated with Transoral Surgery (Laser or Robotic) without neck dissection. From 316 supraglottic cancer we finally selected 66 eligible participants that met all inclusion criteria.

RESULTS:

Sixty-six patients (M 75.8 % vs F 24.2 %), median age 65.8 years (IQR 60.9, 70.5). The most common subsite was the epiglottis (62.1 %). Tumor stage distribution was as follows 35 % cT1, 53 % cT2, 15.2 % cT3. Neither deaths nor major treatment-related complications were reported after surgery. The median follow-up was 62 months. For oncological outcomes, we evaluated 56 patients (10 excluded for adjuvant radiotherapy) 5-year overall survival rate 87 % (CI 95 % 73.1-94), disease- specific survival rate 95.3 % (CI 95 % 82-98.8) and neck recurrence-free survival rate 87 % (CI 95 % 73.1-94). Six patients developed neck recurrence, with a median time of 13 months.

CONCLUSIONS:

Supraglottic carcinoma has been historically associated to a considerable risk of occult metastasis. However, in early-stage cases data are still inconclusive. Our results suggest that in such patients a wait-and-see policy does not impact negatively on survival outcomes, while granting the reduced morbidity associated to a minimally invasive surgical approach.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Carcinoma, Squamous Cell / Laryngeal Neoplasms Limits: Aged / Humans Language: En Journal: Am J Otolaryngol Year: 2024 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Carcinoma, Squamous Cell / Laryngeal Neoplasms Limits: Aged / Humans Language: En Journal: Am J Otolaryngol Year: 2024 Document type: Article Affiliation country: Country of publication: