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Preoperative tracheotomy as reflection of tumor size impacting oncologic outcomes of patients with advanced stage glottic carcinoma

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Abstract

Purpose

The aim of this study was to evaluate the influence of preoperative tracheotomy on oncologic outcomes of advanced stage glottic carcinoma patients, and to explore the potential reason.

Methods

We retrospectively analyzed 413 consecutive advanced stage glottic carcinoma patients from January 2005 to December 2010. The correlation of preoperative tracheotomy and potential impacting factor of tumor size involving tumor diameter and tumor area with overall survival (OS) and disease-free survival (DFS) was fully assessed.

Results

Our cohort consisted of 302 (73.1%) patients with T3 and 111 (26.9%) patients with T4, and 98 (23.7%) patients received preoperative tracheotomy. The OS and DFS rates of patients receiving preoperative tracheotomy were worse than those without (5-year OS: 49.3% versus 69.8%; 5-year DFS: 45.3% versus 61.0%). The mean tumor diameter and tumor area of patients with preoperative tracheotomy were greater than those without (3.3 cm versus 2.4 cm, 8.9 cm2 versus 4.7 cm2). The optimal cutoff values of tumor diameter and tumor area for tracheotomy were 2.85 cm and 6.64 cm2. Tumor diameter and tumor area were correlated with tracheotomy intervention. Furthermore, when considering the potential effect of tumor area in multivariate model, we found that it was a significant factor in survival outcomes but variable of preoperative tracheotomy was not.

Conclusion

This study indicates that tumor size is correlated with preoperative tracheotomy, and tracheotomy intervention may be reflection from effect of great tumor size that is a true adverse factor influencing oncologic outcomes of advanced stage glottic carcinoma patients.

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Funding

This study was funded by Shanghai Hospital Development Center (grant number SHDC12015114), Shanghai Science and Technology Commission (grant number 16411950100), and Shanghai "Rising Stars of Medical Talent" Youth Development Program-Specialist Program (grant number 2019-72).

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China

    Hongli Gong, Liang Zhou, Chunping Wu, Chi-Yao Hsueh, Lei Tao, Haitao Wu, Ming Zhang, Xiaoling Chen, Cai Li & Jian Zhou

Authors
  1. Hongli Gong
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  2. Liang Zhou
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  3. Chunping Wu
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  4. Chi-Yao Hsueh
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  5. Lei Tao
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  6. Haitao Wu
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  7. Ming Zhang
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  8. Xiaoling Chen
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  9. Cai Li
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  10. Jian Zhou
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Contributions

HG collected the clinical data, prepared data, analyzed data, and wrote manuscript. LZ performed the surgery, carried out the study design and revised manuscript. CW performed the surgery, collected the clinical data and prepared data. C-YH performed the surgery, analyzed data and interpreted data. LT performed the surgery, collected the clinical data and prepared data. HW performed the surgery, collected the clinical data and prepared data. MZ performed the surgery, collected the clinical data and prepared data. XC performed the surgery, analyzed data and interpreted data. CL collected the clinical data, analyzed data and interpreted data. JZ analyzed data and interpreted data. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Liang Zhou.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The protocol was approved by the Ethics Committee at the Eye & ENT Hospital, Fudan University.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Gong, H., Zhou, L., Wu, C. et al. Preoperative tracheotomy as reflection of tumor size impacting oncologic outcomes of patients with advanced stage glottic carcinoma. Eur Arch Otorhinolaryngol 278, 4943–4950 (2021). https://doi.org/10.1007/s00405-021-06721-9

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  • DOI: https://doi.org/10.1007/s00405-021-06721-9

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