Organ preservation surgery for patients with T4a laryngeal cancer
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Surgical preservation of laryngeal function is very challenging in patients with advanced SCCL, especially those of stage T4a. The purpose of this study was to assess the feasibility of organ preservation surgery for patients with T4a squamous cell carcinoma of the larynx (SCCL).
We enrolled 32 patients with T4a SCCL and performed organ preservation surgery on them. Surgical details and perioperative morbidity were described, functional and oncologic outcomes were also evaluated.
All patients underwent supracricoid subtotal laryngectomy with unilateral or bilateral neck dissection, restoring laryngeal function via direct anastomosis of the cricoid cartilage and tongue base. The patients recovered well and exhibited relatively acceptable survival duration, with a 5-year overall survival rate of 62.5%. Most patients commenced oral intake within 2 weeks, and aspiration was commonly observed. Subjective functional outcomes indicated a relatively acceptable swallowing function and voice quality.
Our retrospective analysis of 32 patients with T4a SCCL showed that successful organ preservation surgery is safe and reliable, and associated with a relatively acceptable disease-free survival, normal swallowing function, and acceptable voice quality. More patients with T4a SCCL who wish to preserve the larynx should be considered for organ preservation surgery.
KeywordsT4a laryngeal cancer Organ preservation Total laryngectomy Chemoradiation
This work was supported by a grant from the National Natural Science Foundation of China (No. 81502361).
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
The study was approved the ethical standards of the institutional research committee and conducted in accordance to the principles of the Declaration of Helsinki (1964).
General informed consent was obtained from all individual participants included in the study.
- 1.Zhang SS, Xia QM, Zheng RS et al (2015) Laryngeal cancer incidence and mortality in China, 2010. J Cancer Res Ther Suppl 2:C143-8Google Scholar
- 5.Rosen CA, Lee AS, Osborne J, Zullo T, Murry T (2001) Development and validation of the voice handicap index-10. Laryngoscope 11:1549–1556Google Scholar
- 10.Karatzanis AD, Psychogios G, Waldfahrer F et al (2014) Management of locally advanced laryngeal cancer.J Otolaryngol. Head Neck Surg 43:4Google Scholar
- 11.Dziegielewski PT, O’Connell DA, Klein M et al (2012) Primary total laryngectomy versus organ preservation for T3/T4a laryngeal cancer: a population-based analysis of survival. J Otolaryngol Head Neck Surg Suppl 1:S56-64Google Scholar