Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2008
Significance of laryngeal edema after partial laryngectomy and radiotherapy in supraglottic cancer.
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Oksüz Didem Colpan, Uzel Omer, Yildirim Ayşe, Yetmen Ozlem, Sahinler Ismet, Turkan Sedat
Аннотация
OBJECTIVE: To evaluate the impact of the presence of laryngeal edema on outcome and the other potential prognostic factors in patients with supraglottic larynx carcinoma treated with radiotherapy after partial laryngectomy.
DESIGN: A retrospective analysis.
SETTING: Cerrahpaşa Medical Faculty, Istanbul University.
METHODS: Seventy-nine patients with supraglottic carcinoma of the larynx were treated with radiotherapy after partial laryngectomy between January 1980 and July 2003. Neck dissection was not performed in 46 patients. The median follow-up time was 64 months.
MAIN OUTCOME MEASURES: The effect of laryngeal edema grade on local control, disease-free, and actuarial survival rates.
RESULTS: The 5-year locoregional progression-free and overall survival rates were 86% and 75%, respectively. In univariate analysis, histologically positive neck disease reduced regional (p = .0045) and disease-free survival (p = .01). Patients with edema grade III-IV had lower local control (p = .0004), disease-free (p = .0034), and actuarial survival (p = .0041) rates. In the multivariate analysis, a significant negative association of laryngeal edema with local control (p = .012), disease-free survival (p = .002), and actuarial survival (p = .003) was found. Nodal status was a significant prognostic factor for disease-free survival (p = .027). Grade III-IV laryngeal edema was observed in 17 patients. Owing to laryngeal edema, tracheostomy dependence and total laryngectomy were required in three patients and one patient, respectively.
CONCLUSION: Radiotherapy after partial laryngectomy can be performed in patients with poor prognostic factors with reasonable complication rates. However, in the presence of grade III-IV laryngeal edema, tumour recurrence should be suspected, and these patients have to be managed with close follow-up and further evaluation to improve outcome.
DESIGN: A retrospective analysis.
SETTING: Cerrahpaşa Medical Faculty, Istanbul University.
METHODS: Seventy-nine patients with supraglottic carcinoma of the larynx were treated with radiotherapy after partial laryngectomy between January 1980 and July 2003. Neck dissection was not performed in 46 patients. The median follow-up time was 64 months.
MAIN OUTCOME MEASURES: The effect of laryngeal edema grade on local control, disease-free, and actuarial survival rates.
RESULTS: The 5-year locoregional progression-free and overall survival rates were 86% and 75%, respectively. In univariate analysis, histologically positive neck disease reduced regional (p = .0045) and disease-free survival (p = .01). Patients with edema grade III-IV had lower local control (p = .0004), disease-free (p = .0034), and actuarial survival (p = .0041) rates. In the multivariate analysis, a significant negative association of laryngeal edema with local control (p = .012), disease-free survival (p = .002), and actuarial survival (p = .003) was found. Nodal status was a significant prognostic factor for disease-free survival (p = .027). Grade III-IV laryngeal edema was observed in 17 patients. Owing to laryngeal edema, tracheostomy dependence and total laryngectomy were required in three patients and one patient, respectively.
CONCLUSION: Radiotherapy after partial laryngectomy can be performed in patients with poor prognostic factors with reasonable complication rates. However, in the presence of grade III-IV laryngeal edema, tumour recurrence should be suspected, and these patients have to be managed with close follow-up and further evaluation to improve outcome.
Предметные рубрики MeSH
AdultAgedAnalysis of VarianceCarcinoma, Squamous CellCombined Modality TherapyDisease-Free SurvivalFemaleFollow-Up StudiesGlottisHumansKaplan-Meier EstimateLaryngeal EdemaLaryngeal NeoplasmsLaryngectomyMaleMiddle AgedMultivariate AnalysisNeoplasm InvasivenessNeoplasm Recurrence, LocalNeoplasm StagingPostoperative PeriodProbabilityRadiotherapy, AdjuvantRetrospective StudiesRisk AssessmentSurvival AnalysisTreatment Outcome