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Τρίτη 28 Σεπτεμβρίου 2021

Transoral laser microsurgery in locally advanced laryngeal cancer: Prognostic impact of anterior versus posterior compartments

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Abstract

Background

To evaluate the importance of larynx compartments in the prognosis of T3-T4a laryngeal cancer treated with transoral laser microsurgery.

Methods

Two hundred and two consecutive pT3-T4a larynx carcinomas. Pre-epiglottic space involvement, anterior and posterior paraglottic space (PGS) involvement, vocal cord, and arytenoid mobility were determined. Local control with laser (LC), overall survival (OS), disease-specific survival (DSS), and laryngectomy-free survival (LFS) were evaluated.

Results

The lowest LC was found in tumors with fixed arytenoid. In the multivariate analysis, positive margins (hazard ratio [HR] = 0.289 [0.085–0.979]) and anterior (HR = 0.278 [0.128–0.605]) and posterior (HR = 0.269 [0.115–0.630]) PGS invasion were independent factors of a reduced LC. Anterior (HR = 3.613 [1.537–8.495]) and posterior (HR = 5.195 [2.167–12.455]) PGS involvement were independent factors of total laryngectomy. Five-year OS, DSS, and LFS rates were 63.9%, 77.5%, and 77.5%, respectively. Patients with posterior PGS presented a reduced 5-year LFS.

Conclusions

Tumor classification according to laryngeal compartmentalization depicts strong correlation with LC and LFS.

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