TY - JOUR
T1 - Oncologic outcomes after salvage laryngectomy for squamous cell carcinoma of the larynx and hypopharynx : a multicenter retrospective cohort study
AU - Meulemans, Jeroen
AU - Debacker, Jens
AU - Demarsin, Hannelore
AU - Vanclooster, Christophe
AU - Neyt, Peter
AU - Mennes, Tillo
AU - Vauterin, Tom
AU - Huvenne, Wouter
AU - Laenen, Annouschka
AU - Delaere, Pierre
AU - Vander Poorten, Vincent
N1 - Funding Information:
Statistical analysis was funded through the Vandeputte Walter Hoofd-Halskanker fund of the KU Leuven.
Publisher Copyright:
© 2020, Society of Surgical Oncology.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/3
Y1 - 2021/3
N2 - Objective: We aimed to analyze oncologic outcomes and identify patterns of failure and negative prognostic factors in patients who underwent salvage total laryngectomy (STL) for residual, recurrent, and second primary squamous cell carcinoma (SCC) of the larynx and hypopharynx. Methods: This was a retrospective cohort study of patients who underwent STL in four major Belgian reference hospitals between 2002 and 2018 for residual/recurrent/second primary SCC in the larynx or hypopharynx after initial (chemo)radiation. Prognostic factors for oncologic outcomes were identified using univariable and multivariable analysis. Results: A total of 405 patients were included in the final analysis. Five-year overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), and locoregional relapse-free survival (LRFS) estimates were 47.7% (95% confidence interval [CI] 42.0–53.2%), 68.7% (95% CI 63.7–73.7%), 42.1% (95% CI 36.7–47.4%), and 44.3% (95% CI 38.8–49.7%), respectively. In a multivariable model, increasing clinical tumor stage of the residual/recurrent/second primary tumor, increasing number of metastatic cervical lymph nodes retrieved during neck dissection, hypopharyngeal and supraglottic tumor location, positive section margin status and perineural invasion were independent negative prognostic variables for OS, DSS, DFS, and LRFS. The type of second tumor was identified as an additional independent prognosticator for DSS, with local recurrences and second primary tumors having a better prognosis than residual tumor. Conclusions and Relevance: Favorable oncologic outcomes are reported after STL. Increasing clinical tumor stage, increasing number of metastatic cervical lymph nodes, hypopharyngeal and supraglottic tumor location, positive section margins, and perineural invasion are identified as independent negative prognosticators for all oncologic outcome measures.
AB - Objective: We aimed to analyze oncologic outcomes and identify patterns of failure and negative prognostic factors in patients who underwent salvage total laryngectomy (STL) for residual, recurrent, and second primary squamous cell carcinoma (SCC) of the larynx and hypopharynx. Methods: This was a retrospective cohort study of patients who underwent STL in four major Belgian reference hospitals between 2002 and 2018 for residual/recurrent/second primary SCC in the larynx or hypopharynx after initial (chemo)radiation. Prognostic factors for oncologic outcomes were identified using univariable and multivariable analysis. Results: A total of 405 patients were included in the final analysis. Five-year overall survival (OS), disease-specific survival (DSS), disease-free survival (DFS), and locoregional relapse-free survival (LRFS) estimates were 47.7% (95% confidence interval [CI] 42.0–53.2%), 68.7% (95% CI 63.7–73.7%), 42.1% (95% CI 36.7–47.4%), and 44.3% (95% CI 38.8–49.7%), respectively. In a multivariable model, increasing clinical tumor stage of the residual/recurrent/second primary tumor, increasing number of metastatic cervical lymph nodes retrieved during neck dissection, hypopharyngeal and supraglottic tumor location, positive section margin status and perineural invasion were independent negative prognostic variables for OS, DSS, DFS, and LRFS. The type of second tumor was identified as an additional independent prognosticator for DSS, with local recurrences and second primary tumors having a better prognosis than residual tumor. Conclusions and Relevance: Favorable oncologic outcomes are reported after STL. Increasing clinical tumor stage, increasing number of metastatic cervical lymph nodes, hypopharyngeal and supraglottic tumor location, positive section margins, and perineural invasion are identified as independent negative prognosticators for all oncologic outcome measures.
UR - http://www.scopus.com/inward/record.url?scp=85089889721&partnerID=8YFLogxK
U2 - 10.1245/s10434-020-09017-0
DO - 10.1245/s10434-020-09017-0
M3 - Article
VL - 28
SP - 1751
EP - 1761
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
SN - 1068-9265
IS - 3
ER -