• Title/Summary/Keyword: glottic carcinoma

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Is Salvage Vertical Partial Laryngectomy Safe in Patients with Radiation-Failure Carcinoma of the Glottic Larynx? (방사선치료 실패 후의 수직부분후두절제술은 안전한가?)

  • Lim Young-Chang;Lim Jeong-Taek;Kang Joo-Wan;Choi Hyun-Seung;Song Mee-Hyun;Kim Min-Byum;Choi Eun-Chang
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.1
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    • pp.16-20
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    • 2003
  • Objectives: Radiotherapy is an effective treatment in the initial management of T1 glottic carcinoma, but local recurrent or residual tumor growth is found in approximately 10% of the patients. Even in recurrence or residual tumor, in highly selected cases, conservation surgery with preservation of a portion of the larynx is feasible. So we investigated the efficacy of salvage vertical partial laryngectomy for recurrent glottic carcinoma after irradiation. Material and Methods: Retrospectively we reviewed a consecutive series of 10 patients treated by conservative vertical partial laryngectomy of the larynx for radiation-failure, recurrent T1 glottic squamous cell carcinoma treated at Severance Hospital from 1994 to 2002. Results: Local recurrence developed in 4 patients (40%). Two patient was salvaged by further totallaryngectomy. Successful salvage was achieved finally in 8 (80%) of the 10 patients. There was no operative mortality. Postoperative perichondritis was developed in two patients. One was resolved by conservative treatment, but the other has underwent the total laryngectomy. Conclusion: A vertical partial laryngectomy in case of recurrent glottic carcinoma after a course of irridation should be the therapy of choice when stringent criteria are observed.

Clinical Analysis of Laryngectomized Patients (후두전적출술 52 례에 대한 임상통계학적 고찰)

  • Wang Soo-Geun;Chon Kyong-Myong;Lee Jong-Dam
    • Korean Journal of Head & Neck Oncology
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    • v.3 no.1
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    • pp.55-63
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    • 1987
  • A retrospective investigation of 52 cases of carcinoma of the larynx, who underwent total laryngectomy $\bar{c}\;or\;\bar{s}$ neck dissection at Pusan National University Hospital from 1978 to 1985, was performed. The results obtained were as follows: 1) There were 32 glottic(62.7%), 18 supraglottic(35.3%) and 1 subglottic(2.0%) carcinoma. 2) In stage grouping, stage ill was the most(64.7%) and then stage II, stage IV, stage I in order. 3) Overall rate of cervical metastasis was 29.4%. In glottic carcinoma, 0% of $T_1,\;40%\;of\;T_2,\;18%\;of\;T_3\;and\;25%\;of\;T_4$. In supraglottic carcinoma, there was 0% of $T_1,\;29%\;of\;T_2,\;56%\;of\;T_3\;and\;50%\;of\;T_4$. 4) The incidence of postoperative complication was 31.4% and stomal stenosis was the most(13.7%) 5) There were 8 cases of local recurrence and 3 cases of distant metastasis(2 cases in lung, 1 case in esophagus) among 40 cases which were able to follow up. 6) 3 year estimated survival rate for glottic and supraglottic carcinoma were 73.3 % and 85.7% respectively.

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Local Control after Radiation Therapy for T1-T2 Glottic Carcinoma (T1-T2 성문암의 방사선 치료 성적)

  • Kwon, Byung-Hyun;Kim, Dong-Won
    • Radiation Oncology Journal
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    • v.12 no.3
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    • pp.331-336
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    • 1994
  • Purpose : To assess the effectiveness and problems of the primary radiation therapy and salvage surgery in a series of patients affected by T1-T2NO glottic cancers treated from 1985 to 1991 at the Pusan National University Hospital. Materials and Methods : From 8/85 to 12/91,34 patients affected by early glottic carcinoma histologically proven were treated with curative radiation therapy, Distribution of patients according to T stage was 30 for T1 and 4 for T2. Male to female ratio was 33:1. Age of patients ranged from 31 to 73 with mean age of 58 years. All of the patients were treated with radical radiation with total tumor dose of 63-75. 3Gy(median 68.2Gy), of 5 weekly fractions of 1.8-2Gy and with 6MV photon beams through two laterally opposed fields. Results : The overall 5-year local control rates were $74\%$(8/30) for Tl, and $25\%$(3/4) for T2. The main cause of failure was progression or recurrence in T(10/11). One failures were observed in T and N at the same time. Of these 11 patients, 9($81\%$) were salvaged with surgery, After surgical salvage of radiation failures, the 5-year survival rates were $96\%$ for T1 and $75\%$ for T2. Among the survivors, $73\%$ of T1 and $33\%$ of T2 were able to preserve the larynx. Conclusion : It can be concluded that radiotherapy is the first choice in the treatment of glottic T1 carcinoma.

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Transoral $CO_2$ Laser Microsurgery for Glottic Carcinoma (성대암에서 $CO_2$ 레이저를 이용한 경구강절제술)

  • Chung, Phil-Sang;Moon, Tae-Hyun
    • Korean Journal of Bronchoesophagology
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    • v.16 no.1
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    • pp.20-26
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    • 2010
  • Transoral $CO_2$ Laser Microsurgery of glottic Carcinoma is replacing external approaches. The qualify of life after surgery for laryngeal cancer may be as important as complete resection of the tumor for patient. Transoral $CO_2$ laser cordectomy for the management of early laryngeal cancer has advantages with regard to oncological results, preservation of laryngeal functions, morbidity and cost in comparison to those of open surgery or radiation therapy. Moreover, transoral laser surgery can be a useful choice as a salvage surgery in radiation therapy failed early glottic cancer. A classification of laryngeal endoscopic cordectomies which included eight different types was described by the European laryngological Society in 2000. We will also introduce type VI which was newly proposed recently.

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Treatment of Laryngeal Carcinomas by Laser Surgery (후두암의 레이저 수술)

  • 이동욱;김광현
    • Korean Journal of Bronchoesophagology
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    • v.6 no.2
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    • pp.172-176
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    • 2000
  • Background and Objectives: The treatment of laryngeal carcinoma is not settled to date and surgeons have used lasers for a variety of benign and malignant lesions in the larynx with good success. The aim of this study is to evaluate the potential role of laser surgery for laryngeal carcinoma. Materials and Methods : Medical records from patients who had undergone laser surgery for laryngeal carcinoma at Seoul National University Hospital between January 1988 3nd December 1998 were reviewed retrospectively. Results : A total of 47 patients were seen during that period and their mean follow-up length was 29 months. Their local control rate was 91% (94% for glottic T1, 60% for glottic T2, 50% for supraglottic T1 and 100% for supraglottic T2). The cure rate after laser surgery with or without postoperative radiotherapy was 87% and 6 of 47 patients showed local or regional recurrences. For those 6 patients, neck dissection, partial or total laryngectomy with or without postoperative RT were conducted and they were all followed up without evidence of disease. All 47 patients who had undergone laser surgery for laryngeal squamous cell carcinoma were followed up with NED and their larynx preservation rate was 96%. Conclusion: This study demonstrates the oncologic validity of laser surgery to the treatment of unadvanced laryngeal carcinoma. However, strict case selection is needed to avoid locoregional recurrences and consequent salvage operations.

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Intensity-modulated radiation therapy in early stage squamous cell carcinoma of the larynx: treatment trends and outcomes

  • Wegner, Rodney E.;Abel, Stephen;Bergin, John J.;Colonias, Athanasios
    • Radiation Oncology Journal
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    • v.38 no.1
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    • pp.11-17
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    • 2020
  • Purpose: Definitive radiotherapy remains a primary treatment option for early stage glottic cancer. Intensity-modulated radiation therapy (IMRT) has emerged as the standard treatment technique for advanced head and neck cancers, whereas three-dimensional conformal radiotherapy (3D-CRT) has remained standard for early glottic cancers. We used the National Cancer Database (NCDB) to identify predictors of IMRT use and effect on outcome in these patients. Materials and Methods: We queried the NCDB from 2004-2015 for squamous cell carcinoma of the glottic larynx staged Tis-T2N0 treated with radiation alone. Logistic regression was used to identify predictors of IMRT. Cox regression was used to identify factors predictive of overall survival. Propensity matching was conducted to account for indication bias. Results: We identified 15,627 patients, of which 11% received IMRT. IMRT use rose from 2% in 2004 to 16% in 2015. Predictors of IMRT include: increased comorbidity, T2 stage, urban location, chemotherapy, treatment at an academic center, and later treatment year. Predictors of improved survival were female gender, higher income, lower stage, no chemotherapy, academic facility, and more remote year. There was no difference in survival between 3D-CRT and IMRT across all stages. Conclusions: The rate of IMRT use for early stage glottic laryngeal cancer has increased over time. There was no difference in outcome in patients receiving IMRT versus 3D-CRT across the cohort.

Clinico-Epidemiologic Patterns of Laryngeal Cancer: 5-year Results from a Regional Cancer Centre in Northeastern India

  • Nallathambi, Chandran;Yumkhaibam, Sobita Devi;Singh, Laishram Jaichand;Singh, Thaodem Tomcha;Singh, Indibor Yengkhom;Daniel, Nithinraj
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2439-2443
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    • 2016
  • Purpose: To determine the risk factors, clinical symptoms and patterns of spread in laryngeal cancer. Materials and Methods: A cross sectional study was carried out in the Regional Cancer Centre, Imphal, Manipur, India. One hundred and sixteen patients with laryngeal cancer were retrospectively reviewed for epidemiological data and descriptive statistics were reported for various variables. Results: Median age at presentation was 65 years and 32.8% were undernourished at presentation. The male to female ratio was 5.4:1. Heavy smoking and tobacco chewing was associated in 91.4% and 33.6% of patients respectively. Tracheostomy was required in 21.5% leading to diagnosis of laryngeal cancer. Almost all were squamous cell carcinoma with neuroendocrine and verrucous carcinoma accounting for less than 2%. Supraglottic, glottic and trans-glottic tumors were 56.9%, 36.3% and 6.9% respectively. Nodal metastases were seen in 81.8% of supraglottic cancers and 31.6% of glottic cancers with supraglottic involvement. Level II neck nodes were the commonest site followed by level III. Distant metastases (only liver) were apparent in 1.7% at presentation. Including these liver metastases, unresectable cases were limited to 6% of the patients. Conclusions: Tobacco use is implicated in almost all of the cases and the sex ratio has also decreased due to increased female smokers. The supraglottis remains the commonest site and incidence of nodal metastases is higher than in other countries. There is also a higher requirement for tracheostomy at presentation in this region.

The Result of Radiation Therapy of Glottic Laryngeal Carcinoma for 20 Years (성문암(聲門癌) 방사선치료(放射線治療) 20년(年) 성적(成績))

  • Cho Chul-Koo;Koh Kyoung-Hwan;Yoo Seong-Yul
    • Korean Journal of Head & Neck Oncology
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    • v.4 no.1
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    • pp.41-51
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    • 1988
  • To evaluate the result of radiation therapy for twenty years experience, a total of 115 cases of pathologically proven glottic carcinoma had been analyzed according tot survival respectively. All the patients had been treated with radiation therapy in curative intent using Co-60 teletherapy machine. The results are as follows: 1) Accoridng to sex, 5YSR & 10YSR were 58.7% and 50.4% in male patients, and 80.0% & 72.0% in female. 2) According to T staging, 5YSR & 10YSR were 83.4% & 83.4% in T1, 69.2% & 60.0% in T2, 34.3% & 21.8% in T3, 32.0% & 0% in T4. 3) According to N staging, 5YSR & 10YSR were 63.8% & 59.2% in node-negative groups, and 30.7% & 15.4% in node-positive groups. 4) According to the histologic grade, 5YSR & 10YSR were 66.8% & 57.6% in G1, 61.3% 54.3% in G2, and 35.0% 35.0% in G3. 5) According to AJC staging, 5YSR & 10YSR were 83.4%% 83.4% in stage I, 72.0% & 62.7% in stage II, 36.8% & 28.3% in stage III, and 14.3% & 7.1% in stage IV. 6) In summary, 5YSR & 10YSR wre 60.4% & 52.8% in glottic carcinoma.

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