Oncological Outcome of Transoral Laser Surgery in Laryngeal Carcinomas

2010 ◽  
Vol 2 (3) ◽  
pp. 237-240
Author(s):  
H Sadick ◽  
K Hörmann

Abstract The principles of treatment of laryngeal carcinoma have undergone changes over the last few years and can be very complex with early (I-II) and advanced (III-IV) stage diseases to be differentiated. Recent emphasis is on organ preservation and laryngeal function. Transoral CO2 laser surgery has become a standard surgical procedure not only in early stage I and II laryngeal carcinomas but also in advanced stage III cases in combination with postoperative adjuvante radiochemotherapy. This retrospective study reflects the role of transoral laser surgery as a single or multimodality treatment regime with neck dissection and postoperative radiochemotherapy in laryngeal carcinomas. From January 1997 to February 2007, 239 patients (215 men and 24 women; mean age 61 years) were examined with laryngeal squamous cell carcinoma (stage I-IV). 220 out of these 239 patients underwent transoral laser surgery, depending on their tumor stage either as a single or as a multimodality treatment regimen in combination with bilateral neck dissection and postoperative radio-chemotherapy. Thirteen patients underwent a transcervical tumor resection, 5 patients underwent radiochemotherapy alone and one patient refused a treatment of his tumor disease. Median follow-up time was 60 months. The 5-year overall survival rate of the 220 patients who were treated with laser surgery was 86%. The 5-year recurrence-free survival rate was 69.5%. After laser surgical interventions, postoperative complications occurred in 16%. The oncological outcome of transoral laser surgery as a single mode in early laryngeal carcinomas or in combination with bilateral neck dissection and postoperative adjuvant radiochemotherapy in advanced tumor stages is satisfying if clean surgical tumor margins (R0) can be reached. If tumor-free margins cannot be achieved (R1 and R2 resection) and transoral revision is not possible, transcervical procedures (total or partial laryngectomy) must be considered.

Oral Oncology ◽  
2011 ◽  
Vol 47 ◽  
pp. S69-S70
Author(s):  
A.M. Eckardt ◽  
G. Wegener ◽  
M. Rana ◽  
G. Diebler ◽  
S. Muscia ◽  
...  

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Chang-Ming Huang ◽  
Jian-Xian Lin ◽  
Chao-Hui Zheng ◽  
Ping Li ◽  
Jian-Wei Xie ◽  
...  

Objectives. To investigate the prognostic impact of the number of dissected lymph nodes (LNs) in gastric cancer after curative distal gastrectomy.Methods. The survival of 634 patients who underwent curative distal gastrectomy from 1995 to 2004 was retrieved. Long-term surgical outcomes and associations between the number of dissected LNs and the 5-year survival rate were investigated.Results. The number of dissected LNs was one of the most important prognostic indicators. Among patients with comparable T category, the larger the number of dissected LNs was, the better the survival would be (). The linear regression showed that a significant survival improvement based on increasing retrieved LNs for stage II, III and IV (). A cut-point analysis yields the greatest variance of survival rate difference at the levels of 15 LNs (stage I), 25 LNs (stage II) and 30 LNs (stage III).Conclusion. The number of dissected LNs is an independent prognostic factor for gastric cancer. To improve the long-term survival of patients with gastric cancer, removing at least 15 LNs for stage I, 25 LNs for stage II, and 30 LNs for stage III patients during curative distal gastrectomy is recommended.


1990 ◽  
Vol 83 (11) ◽  
pp. 1717-1723
Author(s):  
Yoshifumi Kobayashi ◽  
Yutaka Hayashi ◽  
Megumi Kumai ◽  
Tokuji Unno

2016 ◽  
Vol 2016 ◽  
pp. 1-2
Author(s):  
Lokman Uzun ◽  
Oğuz Kadir Eğilmez ◽  
M. Tayyar Kalcioglu ◽  
Muhammet Tekin

Specifically in neck level IIb, the expected normal anatomy does not contain any vital structures and consequently it might direct a surgeon to perform rapid surgical dissection of tissues. Therefore aberrant anatomy of the vessels in the patients may be overlooked during neck dissection. Unexpected and potentially devastating injuries can be avoided by respecting the possible aberrant anatomy in any level of the neck. In this case report, a 74-year-old man was presented with laryngeal carcinoma who was treated with laryngectomy and bilateral neck dissection. During the left side neck dissection, tortuous internal carotid artery imitating a metastatic mass was unexpectedly encountered in level IIb. As in this case, surgeons should keep in mind possible aberrant anatomy during the neck dissection and perform surgery staying in surgical principles to be safe for an unforeseen and potential dangerous injuries.


Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 291
Author(s):  
Anne Hendricks ◽  
Sophie Müller ◽  
Martin Fassnacht ◽  
Christoph-Thomas Germer ◽  
Verena A. Wiegering ◽  
...  

(1) Background: Locoregional lymphadenectomy (LND) in adrenocortical carcinoma (ACC) may impact oncological outcome, but the findings from individual studies are conflicting. The aim of this systematic review and meta-analysis was to determine the oncological value of LND in ACC by summarizing the available literature. (2) Methods: A systematic search on studies published until December 2020 was performed according to the PRISMA statement. The primary outcome was the impact of lymphadenectomy on overall survival (OS). Two separate meta-analyses were performed for studies including patients with localized ACC (stage I–III) and those including all tumor stages (I–IV). Secondary endpoints included postoperative mortality and length of hospital stay (LOS). (3) Results: 11 publications were identified for inclusion. All studies were retrospective studies, published between 2001–2020, and 5 were included in the meta-analysis. Three studies (N = 807 patients) reported the impact of LND on disease-specific survival in patients with stage I–III ACC and revealed a survival benefit of LND (hazard ratio (HR) = 0.42, 95% confidence interval (95% CI): 0.26–0.68). Based on results of studies including patients with ACC stage I–IV (2 studies, N = 3934 patients), LND was not associated with a survival benefit (HR = 1.00, 95% CI: 0.70–1.42). None of the included studies showed an association between LND and postoperative mortality or LOS. (4) Conclusion: Locoregional lymphadenectomy seems to offer an oncologic benefit in patients undergoing curative-intended surgery for localized ACC (stage I–III).


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