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.

Voice outcomes following transoral laser microsurgery for early glottic squamous cell carcinoma

2007 ◽  
Vol 121 (12) ◽  
pp. 1184-1188 ◽  
Author(s):  
J T Kennedy ◽  
P M Paddle ◽  
B J Cook ◽  
P Chapman ◽  
T A Iseli
Keyword(s):  
Glottic Cancer ◽  
Transoral Laser Microsurgery ◽  
Laser Microsurgery ◽  
Early Glottic Cancer ◽  
Primary Radiotherapy ◽  
Second Procedure ◽  
European Laryngological Society ◽  
Choice Of Therapy ◽  
Salvage Laryngectomy

AbstractIntroduction:Early glottic cancer may be treated with primary radiotherapy or transoral laser microsurgery with comparable survival. The choice of therapy therefore depends on patient preference after discussion of risks, benefits and alternatives.Materials and methods:All previously untreated patients undergoing transoral laser microsurgery for T1 or T2 glottic cancer at St Vincent's Hospital between July 1997 and December 2004 had their staging and demographics recorded. Surgery was categorised according to the European Laryngological Society. A voice recording was made pre-operatively then at 12 weeks post-operatively and scored by two independent speech therapists on the Oates Russell Voice Profile – a scale of zero (normal) to five (severe dysphonia). Follow up was for a minimum of two years.Results and analysis:Fifty-three patients with a mean age of 56 were included. The observed survival was T1 89.4 per cent and T2 85.3 per cent after a mean follow up of 47 months. Nineteen patients staged T1 underwent cordectomy. A second procedure was required in 22.2 per cent, however, none required a laryngectomy. Thirty-four patients staged T2 underwent hemilaryngectomy. A second procedure was required in 41.2 per cent including 8.8 per cent requiring salvage laryngectomy. One patient died with unresectable nodal disease. The mean Oates Russell Voice Profile for T1 disease was 2.37 and for T2 2.68 (range 1 to 4) indicating a mild (2) to moderate (3) degree of voice impairment.Conclusions:Survival outcomes following transoral laser microsurgery are comparable to treatment with radiotherapy. Voice impairment is usually mild to moderate following transoral laser microsurgery for early glottic cancer but overall may be greater than in radiotherapy patients. The repeatability of transoral laser microsurgery may result in a lower laryngectomy rate compared with published series using radiotherapy.

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.

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 Medication-Related Osteonecrosis of Jaws (MRONJ) Prevention and Diagnosis: Italian Consensus Update 2020

2020 ◽  
Vol 17 (16) ◽  
pp. 5998 ◽  
Author(s):  
Giuseppina Campisi ◽  
Rodolfo Mauceri ◽  
Francesco Bertoldo ◽  
Giordana Bettini ◽  
Matteo Biasotto ◽  
...  
Keyword(s):  
At Risk ◽  
Maxillofacial Surgery ◽  
Oral Pathology ◽  
Consensus Conference ◽  
Decision Making Process ◽  
Dental Management ◽  
Patients At Risk ◽  
The Common

The Medication-Related Osteonecrosis of Jaws (MRONJ) diagnosis process and its prevention play a role of great and rising importance, not only on the Quality of Life (QoL) of patients, but also on the decision-making process by the majority of dentists and oral surgeons involved in MRONJ prevention (primary and secondary). The present paper reports the update of the conclusions from the Consensus Conference—held at the Symposium of the Italian Society of Oral Pathology and Medicine (SIPMO) (20 October 2018, Ancona, Italy)—after the newest recommendations (2020) on MRONJ were published by two scientific societies (Italian Societies of Maxillofacial Surgery and Oral Pathology and Medicine, SICMF and SIPMO), written on the inputs of the experts of the Italian Allied Committee on ONJ (IAC-ONJ). The conference focused on the topic of MRONJ, and in particular on the common practices at risk of inappropriateness in MRONJ diagnosis and therapy, as well as on MRONJ prevention and the dental management of patients at risk of MRONJ. It is a matter of cancer and osteometabolic patients that are at risk since being exposed to several drugs with antiresorptive (i.e., bisphosphonates and denosumab) or, more recently, antiangiogenic activities. At the same time, the Conference traced for dentists and oral surgeons some easy applicable indications and procedures to reduce MRONJ onset risk and to diagnose it early. Continuous updating on these issues, so important for the patient community, is recommended.

Quality of life and voice assessment in patients with early-stage glottic cancer

Head & Neck ◽  
2014 ◽  
Vol 37 (3) ◽  
pp. 340-346 ◽  
Author(s):  
Fernando Arias ◽  
Juan Ignacio Arraras ◽  
Gemma Asin ◽  
María Itziar Uzcanga ◽  
Enrique Maraví ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Early Stage ◽  
Glottic Cancer ◽  
Voice Assessment

scholarly journals Could Primary Chemoradiotherapy in T2 Glottic Cancers Yield Results Comparable to Primary Radiotherapy in T1? Considerations from 531 German Early Stage Patients

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1601
Author(s):  
Gerhard Dyckhoff ◽  
Rolf Warta ◽  
Christel Herold-Mende ◽  
Elisabeth Rudolph ◽  
Peter K. Plinkert ◽  
...  
Keyword(s):  
Early Stage ◽  
Multivariable Analysis ◽  
Glottic Cancer ◽  
Altered Fractionation ◽  
Number Of Patients ◽  
Significant Difference ◽  
Observational Cohort ◽  
Radiotherapy Alone ◽  
Primary Chemoradiotherapy ◽  
Primary Radiotherapy

T1 glottic cancer is a highly treatable disease with local control (LC) rates over 90% by either primary radiotherapy (pRT) or transoral laser microsurgery (TLM). LC of T2 glottic cancers is 15 percent points poorer on average. However, salvage after pRT entails more than 50% total laryngectomy. Therefore, there is a need for enhanced LC. Altered fractionation regimens improved LC in T1 but not in T2. For this reason, for T2, alternative strategies must be considered. In a large observational cohort study including 531 early-stage laryngeal cancers, a small number of patients were treated with primary chemoradiotherapy (pCRT). In multivariable analysis, factors associated with significantly poorer outcomes included age, comorbidities, supraglottic localization, and T category. While there was a significant difference between pRT and surgery (HR 1.79; 95%-CI: 1.15–2.79), there was none between pCRT and surgery (HR 0.70; 95%-CI: 0.33–1.51). There is evidence from the literature that pCRT in early glottic cancers could yield results that surpass the limits so far experienced in radiotherapy alone with acceptable toxicity. Thus, prospective randomized studies with larger numbers of patients are warranted.

Oesophageal cancer

2016 ◽  
pp. 365-387
Author(s):  
Melissa Thomas ◽  
Karin Haustermans ◽  
Eric Van Cutsem ◽  
Piet Dirix ◽  
Xavier Sagaert ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Adjuvant Radiotherapy ◽  
Palliative Treatment ◽  
Early Stage ◽  
Locally Advanced ◽  
Adjuvant Chemoradiotherapy ◽  
Valuable Alternative ◽  
Early Stage Carcinoma

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 tumours 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.

Oesophageal cancer

2016 ◽  
pp. 365-387
Author(s):  
Piet Dirix ◽  
Reinhilde Weytjens ◽  
Sabine Vanderkam ◽  
Karin Haustermans ◽  
Eric Van Cutsem ◽  
...  
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.

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