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01-07-2014 | Original article

Squamous cell carcinoma of the larynx with subglottic extension: is larynx preservation possible?

Authors: A. Levy, P. Blanchard, S. Temam, M.-M. Maison, F. Janot, H. Mirghani, F. Bidault, J. Guigay, A. Lusinchi, J. Bourhis, N. Daly-Schveitzer, Y. Tao, MD, PhD

Published in: Strahlentherapie und Onkologie | Issue 7/2014

Abstract

Purpose

Squamous cell carcinoma of larynx with subglottic extension (sSCC) is a rare location described to carry a poor prognosis. The aim of this study was to analyze outcomes and feasibility of larynx preservation in sSCC patients.

Patients and methods

Between 1996 and 2012, 197 patients with sSCC were treated at our institution and included in the analysis. Stage III–IV tumors accounted for 76 %. Patients received surgery (62 %), radiotherapy (RT) (18 %), or induction chemotherapy (CT) (20 %) as front-line therapy.

Results

The 5-year actuarial overall survival (OS), locoregional control (LRC), and distant control rate were 59 % (95 % CI 51–68), 83 % (95 % CI 77–89), and 88 % (95 % CI 83–93), respectively, with a median follow-up of 54.4 months. There was no difference in OS and LRC according to front-line treatments or between primary subglottic cancer and glottosupraglottic cancers with subglottic extension. In the multivariate analysis, age > 60 years and positive N stage were the only predictors for OS (HR 2, 95 % CI 1.2–3.6; HR1.9, 95 % CI 1–3.5, respectively). A lower LRC was observed for T3 patients receiving a larynx preservation protocol as compared with those receiving a front-line surgery (HR 14.1, 95 % CI 2.5–136.7; p = 0.02); however, no difference of ultimate LRC was observed according to the first therapy when including T3 patients who underwent salvage laryngectomy (p = 0.6). In patients receiving a larynx preservation protocol, the 5-year larynx-preservation rate was 55 % (95 % CI 43–68), with 36 % in T3 patients. The 5-year larynx preservation rate was 81 % (95 % CI 65–96) and 35 % (95 % CI 20–51) for patients who received RT or induction CT as a front-line treatment, respectively.

Conclusion

Outcomes of sSCC are comparable with other laryngeal cancers when managed with modern therapeutic options. Larynx-preservation protocols could be a suitable option in T1–T2 (RT or chemo-RT) and selected T3 sSCC patients (induction CT).

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Title: Squamous cell carcinoma of the larynx with subglottic extension: is larynx preservation possible?
Authors: A. Levy
P. Blanchard
S. Temam
M.-M. Maison
F. Janot
H. Mirghani
F. Bidault
J. Guigay
A. Lusinchi
J. Bourhis
N. Daly-Schveitzer
Y. Tao, MD, PhD
Publication date: 01-07-2014
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 7/2014
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-014-0647-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Squamous cell carcinoma of the larynx with subglottic extension: is larynx preservation possible?

Abstract

Purpose

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Patients and methods

Results

Conclusion

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