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Open partial horizontal laryngectomy and adjuvant (chemo)radiotherapy for laryngeal squamous cell carcinoma: results from a multicenter Italian experience

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Abstract

Purpose

To evaluate the functional and oncologic outcomes of adjuvant (chemo)radiation [(C)RT] after open partial horizontal laryngectomies (OPHLs).

Methods

Multicenter retrospective evaluation of 130 patients (116 males, 14 females) submitted between 1995 and 2017 to OPHL Types II and III for laryngeal cancer and receiving adjuvant (C)RT for one or more of the following risk factors at histopathologic examination of the surgical specimen: pT4a and/or > pN2a categories, close/positive resection margins, or presence of both perineural (PNI) and lympho-vascular invasion (LVI). The primary study endpoints were evaluation of the presence of tracheostomy and/or gastrostomy at last follow-up, and calculation of laryngo-esophageal dysfunction-free survival (LEDFS).

Results

Mean age of the study cohort was 60.8 ± 8.9 years (median, 62; interquartile range [IQR], 13). Mean follow-up was 50.7 ± 39.4 months (range 24–188; median, 38; IQR, 51). Adjuvant therapy consisted of CRT in 53 (41%) patients, and RT alone in 77 (59%). Five-year LEDFS was 85%. Overall survival was 71.5%, while 13% of patients remained tracheostomy- and 3% gastrostomy-dependent at the last follow-up. The only significant variable in predicting survival (p = 0.020) was tracheostomy dependence: it was maintained in 7.5% of subjects after OPHL Type II and in 34% of those submitted to OHPL Type III (p < 0.001).

Conclusions

In selected patients affected by advanced laryngeal cancer, OPHLs Type II and III have a relatively good laryngeal safety profile and provide favorable oncologic outcomes even in case of need for adjuvant (C)RT.

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Data availability

The data that support the findings of this study are available from the corresponding author, RL, upon reasonable request.

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Acknowledgments

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Funding

Authors declare that they didn't receive any financial support.

Author information

Authors and Affiliations

  1. Unit of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Versilia Hospital, Camaiore (LU), Italy

    Luca Muscatello

  2. Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan, Milan, Italy

    Cesare Piazza

  3. Department of Oncology and Oncohematology, University of Milan, Milan, Italy

    Cesare Piazza

  4. Department of Otorhinolaryngology, Head and Neck Surgery, University of Genoa, Genoa, Italy

    Giorgio Peretti & Filippo Marchi

  5. Otolaryngology Service, Vittorio Veneto Hospital, Vittorio Veneto (TV), Italy

    Andy Bertolin & Giuseppe Rizzotto

  6. Head and Neck Oncology Service, Candiolo Cancer Institute, FPO IRCCS, Candiolo (TO), Italy

    Erika Crosetti & Giovanni Succo

  7. Unit of Otorhinolaryngology, Azienda USL Toscana Centro, San Giuseppe Hospital, Empoli (FI), Italy

    Gianluca Leopardi

  8. Unit of Otorhinolaryngology, Azienda USL Toscana Nord Ovest, Apuane Hospital, Via E. Mattei 31, 54100, Massa, Italy

    Riccardo Lenzi & Jacopo Matteucci

  9. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

    Laura Manca

  10. Department of Mathematics, University of Pisa, Pisa, Italy

    Laura Manca

  11. Department of Otolaryngology, Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Rome, Italy

    Raul Pellini & Gerardo Petruzzi

  12. Department of Otolaryngology, Head and Neck Surgery, University of Modena and Reggio Emilia, Policlinico Di Modena, Modena, Italy

    Livio Presutti & Sara Valerini

  13. Unit of Otorhinolaryngology, Azienda USL Toscana Centro, Santo Stefano Hospital, Prato, Italy

    Antonio Sarno

Authors
  1. Luca Muscatello
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  2. Cesare Piazza
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  15. Giovanni Succo
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Corresponding author

Correspondence to Riccardo Lenzi.

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The study was approved by the local Ethics Committee of the first author's (LM) affiliation.

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Muscatello, L., Piazza, C., Peretti, G. et al. Open partial horizontal laryngectomy and adjuvant (chemo)radiotherapy for laryngeal squamous cell carcinoma: results from a multicenter Italian experience. Eur Arch Otorhinolaryngol 278, 4059–4065 (2021). https://doi.org/10.1007/s00405-021-06651-6

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  • DOI: https://doi.org/10.1007/s00405-021-06651-6

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