scholarly journals T1b Glottic Tumor and Anterior Commissure Involvement: Is the Transoral CO2 Laser Microsurgery a Safe Option?

2020 ◽  
Vol 100 (1_suppl) ◽  
pp. 68S-72S
Author(s):  
Juan Antonio Cabrera-Sarmiento ◽  
Juan Carlos Vázquez-Barro ◽  
Jesús Herranz González-Botas ◽  
Carlos Chiesa-Estomba ◽  
Miguel Mayo-Yáñez
Keyword(s):  
Laser Therapy ◽  
Local Control ◽  
Organ Preservation ◽  
Randomized Trials ◽  
Early Stage ◽  
Anterior Commissure ◽  
Local Recurrences ◽  
Laryngeal Tumors

Objectives: Transoral CO2 laser therapy represents the treatment of choice for early-stage laryngeal tumors. The anterior commissure involvement (ACI) is related to a worse local control and a lower rates of organ preservation. The objective of this study is to analyze the differences in survival, local control, and organ preservation in T1b glottic patients according to the presence of ACI. Methods: Observational prospective study in pT1b treated with transoral CO2 laser between 2009 and 2014. Results: Forty patients (37 male and 3 female) with a mean age of 66.43 ± 8.16 years were recruited. Anterior commissure involvement was present in 70% of the patients. The 5-year specific cause survival was 91.66%, with 32.50% of local recurrences. Laryngeal preservation was 80%, being lower in the group with local recurrence ( P < .000). The involvement of the anterior commissure does not influence the organ preservation ( P = .548), the appearance of local recurrences ( P = .391), or the survival ( P = .33). Conclusions: Transoral CO2 laser therapy is an effective and reproducible treatment for early-stage laryngeal tumors. The results obtained are similar to previous studies, although they present discrepancies in relation to the role of the ACI. Prospective randomized trials are required focusing also on the patients’ quality of life and functional outcome in order to clarify the role of the ACI and the need to implement changes in its evaluation, staging, and evolution.

Decreased Local Control Following Radiation Therapy Alone in Early-Stage Glottic Carcinoma with Anterior Commissure Extension*

2004 ◽  
Vol 180 (2) ◽  
pp. 84-90 ◽  
Author(s):  
Abderrahim Zouhair ◽  
David Azria ◽  
Philippe Coucke ◽  
Oscar Matzinger ◽  
Luc Bron ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Local Control ◽  
Early Stage ◽  
Anterior Commissure ◽  
Glottic Carcinoma

scholarly journals Outcome of Early-Stage Glottic Laryngeal Carcinoma Patients Treated with Radical Radiotherapy Using Different Techniques

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Oguz Cetinayak ◽  
Ersoy Dogan ◽  
Ahmet Kuru ◽  
Nesrin Akturk ◽  
Barbaros Aydin ◽  
...  
Keyword(s):  
Local Control ◽  
Laryngeal Carcinoma ◽  
Early Stage ◽  
Anterior Commissure ◽  
Conventional Technique ◽  
Radical Radiotherapy ◽  
Treatment Techniques ◽  
Median Total Dose ◽  
Effective Treatment Modality ◽  
Laryngeal Carcinomas

Purpose. The aim was to evaluate the treatment outcomes and prognostic characteristics of patients with early-stage glottic laryngeal carcinoma who underwent radical radiotherapy (RT) with different techniques. Patients and Methods. Radiotherapy was applied using the 2D conventional technique between 1991 and 2004 (130 patients), 3DCRT until 2014 (125 patients), and by VMAT until January 2017 (44 patients). Clinical T stages were 38 (12.7%) for Tis, 209 (69.9%) for T1, and 52 (17.4%) for T2. Radiotherapy technique and energy, anterior commissure involvement, and stage were analyzed as prognostic factors. Results. The median total dose was 66 (50–70) Gy, and median follow-up time was 72 (3–288) months; 5-year disease-specific survival (DSS) rates were 95.8%, 95.5%, and 88.6%, respectively, in Tis, T1, and T2 stages. In multivariate analyses, anterior commissure involvement was found significant for all survival and local control rates. The patients treated with VMAT technique had better local control and DSS rates. However, these results were not statistically significant. Conclusion. In early-stage laryngeal carcinomas, radical RT is a function sparing and effective treatment modality, regardless of treatment techniques.

scholarly journals Surgery treatment of laryngeal carcinoma T1

2004 ◽  
Vol 51 (1) ◽  
pp. 20-25
Author(s):  
A. Mikic ◽  
Z. Petrovic ◽  
Vojko Djukic ◽  
Milovan Dimitrijevic ◽  
P. Stankovic ◽  
...  
Keyword(s):  
Early Stage ◽  
Maxillofacial Surgery ◽  
Incidence Rates ◽  
Glottic Cancer ◽  
Clinical Center ◽  
Regional Metastases ◽  
Primary Radiotherapy ◽  
European Laryngological Society

The early stage cancer of the glottis, including Tis, Tla and Tlb stages, are the most common forms with the incidence rates ranging from 25% to 85%. The therapy of early glottic cancer is usually successful for two reasons. First, true glottic cancer produces early symptoms and it is relatively easy to remove. Second, glottis is rather poor with lymph pathways so the regional metastases are rare, less than 1 %. Due to role of the larynx in phonation, respiration and swallowing, the cancer of this region and its treatment has a great impact to the quality of life. Retrospective study involved ten-year period, from January 1990 to January 2004. At the Institute for Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Serbia, 858 surgical and 54 endoscopie CO2 laser-assisted resections were performed for glottic cancers of larynx of Tis-T2 stages. Glottic tumors were treated by Types III, IV and Va chordectomies according to classificaiton of endoscopie chordectomy defined by the European Laryngological Society. Analyzing the operated patients, as well as the type of the applied surgery, that is, endoscopic-laser and classic surgery, the authors attempted to clarify the dilemmas relating to the indications for one or another type of surgical intervention. The patients who had undergone primary radiotherapy were excluded from the analysis.

scholarly journals Salvage Surgery in Head and Neck Cancer

2021 ◽  
pp. 233-246
Author(s):  
Stijn van Weert ◽  
Sat Parmar ◽  
C. René Leemans
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Organ Preservation ◽  
Salvage Surgery ◽  
Transoral Robotic Surgery ◽  
Shared Decision ◽  
Surgery Complications

AbstractSalvage surgery (SS) in head and neck cancer is considered a last resort treatment after failure of organ preservation treatments. It offers challenges to the patients and the surgeon. The outcome of SS is often uncertain in terms of survival and quality of life. This paper offers an overview of evolution in SS, tumor and patient factors to be considered, challenges in reconstructive surgery, complications of SS and the changing landscape with regard to increasing incidence of human papillomavirus positive tumours, the role of transoral robotic surgery, the importance of multidisciplinary management and shared decision making.

scholarly journals Management of Moderate and Severe Forms of Psoriasis in Children: New Opportunities of Genetically Engineered Biologic Drugs

2021 ◽  
Vol 20 (5) ◽  
pp. 446-450
Author(s):  
Leyla S. Namazova-Baranova ◽  
Andrey L. Bakulev ◽  
Nikolay N. Murachkin ◽  
Lyudmila N. Nam ◽  
Roman A. Ivanov
Keyword(s):  
Quality Of Life ◽  
Children And Adolescents ◽  
Randomized Trials ◽  
Genetically Engineered ◽  
Efficacy And Safety ◽  
Biologic Drugs ◽  
Biologic Drug ◽  
Psoriasis Severity

The article shows the key role of IL-17 in the psoriasis pathogenesis and the opportunities of its management via monoclonal antibodies product secukinumab. The review of international randomized trials on clinical efficacy and safety of genetically engineered biologic drug secukinumab in children and adolescents with psoriasis is presented. During treatment periods of 12 to 52 weeks, secukinumab has shown high therapeutic efficacy for psoriasis severity and skin lesion areas and has improved quality of life of children and adolescents according to dynamic assessments of PASI, IGA 0/1 mod 2011 indices, CDLQI questionnaire. The safety profile of secukinumab in children is estimated as favorable and comparable to using it in adults.

Oesophageal cancer

2016 ◽  
pp. 365-387
Author(s):  
Piet Dirix ◽  
Karin Haustermans ◽  
Eric Van Cutsem ◽  
Xavier Sagaert ◽  
Christophe M. Deroose ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Palliative Treatment ◽  
Early Stage ◽  
Locally Advanced ◽  
Adjuvant Chemoradiotherapy ◽  
Locally Advanced Tumors ◽  
Early Stage Carcinoma ◽  
Advanced Tumors

Worldwide, oesophageal cancer, including cancer of the gastro-oesophageal junction (GEJ), is the sixth leading cause of death from cancer. Despite recent advances, treatment of oesophageal cancer remains challenging and is best approached by an experienced multidisciplinary team. Surgery alone is the treatment of choice in early stage carcinoma although in superficial cancers (T1a) endoscopic resection is to be preferred. In locally advanced tumors induction therapy followed by surgery is the preferred treatment. In selected cases definitive chemoradiotherapy could be considered as a valuable alternative The role of adjuvant chemotherapy is unclear, but could be considered for selected GEJ adenocarcinoma patients. Adjuvant chemoradiotherapy should be considered in all patients with advanced disease or positive margins who did not receive neo-adjuvant radiotherapy. For metastatic disease, the goal is to prolong and maximize quality of life. Regarding the palliative treatment of dysphagia, brachytherapy was shown to be more effective than stenting.

scholarly journals Quality of Life in Patients with Larynx Cancer in Latin America: Comparison between Laryngectomy and Organ Preservation Protocols

2018 ◽  
Vol 97 (3) ◽  
pp. 83-90 ◽  
Author(s):  
Alvaro Sanabria ◽  
Daniel Sánchez ◽  
Andrés Chala ◽  
Andres Alvarez
Keyword(s):  
Quality Of Life ◽  
Latin America ◽  
Organ Preservation ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Laryngeal Tumors ◽  
Clinically Significant ◽  
The University

The effect on quality of life (QOL) of laryngectomy and organ preservation protocols is important in decision making. The aim of this cross-sectional study was to evaluate QOL outcomes of patients with advanced laryngeal tumors who were treated with laryngectomy or organ preservation protocols in Latin America. A total of 35 patients from three oncology units were enrolled. Patients with stage III/IV laryngeal cancer who were treated using organ preservation protocols or laryngectomy were assessed with the University of Washington QOL Questionnaire. The most important domains that affected QOL for both groups were speech and activity. In the laryngectomy group, the next most important domains were appearance, taste, pain, and recreation, whereas in the organ preservation group, they were saliva, recreation, mood, and swallowing. There were no statistically or clinically significant differences in the global score or the 7 days of QOL assessments before patients were interviewed. Global QOL assessments were similar when comparing laryngectomy and organ preservation protocols.

Sign in / Sign up

Export Citation Format

Share Document