T3-T4 laryngeal cancer in The Netherlands Cancer Institute; 10-year results of the consistent application of an organ-preserving/-sacrificing protocol

• Published in: Head & neck Vol. 37; no. 10; pp. 1495 - 1503
• Main Authors: Timmermans, Adriana J., de Gooijer, Cornedine J., Hamming-Vrieze, Olga, Hilgers, Frans J.M., van den Brekel, Michiel W.M.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.10.2015; Wiley Subscription Services, Inc
• Subjects: Adult; advanced stage; Aged; Chemoradiotherapy - methods; Cohort Studies; Combined Modality Therapy; Female; Humans; laryngeal cancer; Laryngeal Neoplasms - pathology; Laryngeal Neoplasms - surgery; Laryngeal Neoplasms - therapy; Laryngectomy - methods; Male; Middle Aged; Neoplasm Staging; Netherlands; organ-preserving treatment; overall survival; Retrospective Studies; Survival Rate; total laryngectomy; Netherlands; overall survival; laryngeal cancer; organ-preserving treatment; advanced stage; total laryngectomy
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.23789

ABSTRACT Background Both organ‐preserving concurrent (chemo)radiotherapy ((C)RT) and organ‐sacrificing surgery (total laryngectomy) are used for treatment of advanced laryngeal cancer. The purpose of this study was to present the assessment of our treatment protocol for T3 (C)RT and T4 disease (total laryngectomy + postoperative RT). Methods We conducted a retrospective cohort study in 182 consecutive patients (1999–2008). The primary outcome was overall survival (OS) in relation to stage and treatment. Results One hundred two patients received RT (82.4% T3), 20 patients CRT (60.0% T3), and 60 patients total laryngectomy + RT (91.7% T4). Five‐year OS: T3 52%, T4 48%, for RT 50%, for CRT 43%, and for total laryngectomy + RT 52%. Five‐year laryngectomy‐free interval was 72% after RT, and 83% after CRT. Conclusion There were no differences in survival according to T classification or treatment modality. Because the majority of T3 laryngeal cancers were treated with (C)RT and the majority of T4 with total laryngectomy + RT, this gives food for thought on whether the present protocol for T3 laryngeal cancer is optimal. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1495–1503, 2015