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Treatment outcomes of laryngectomy compared to non-surgical management of T3 laryngeal carcinomas: a 10-year multicentre audit of 179 patients in the northeast of England

Published online by Cambridge University Press:  12 January 2021

D J Lin ,
M Goodfellow ,
J Ong ,
M Y Chin ,
L Lazarova  and
H C Cocks
D J Lin*
Affiliation:
ENT Department, City Hospitals Sunderland NHS Foundation Trust, Sunderland, UK ENT Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
M Goodfellow
Affiliation:
Newcastle Medical School, Newcastle University, Newcastle upon Tyne, UK
J Ong
Affiliation:
ENT Department, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
M Y Chin
Affiliation:
ENT Department, North Cumbria University Hospital, Carlisle, UK
L Lazarova
Affiliation:
ENT Department, North Cumbria University Hospital, Carlisle, UK
H C Cocks
Affiliation:
ENT Department, City Hospitals Sunderland NHS Foundation Trust, Sunderland, UK
*
Author for correspondence: Mr Daniel J Lin, ENT Department, Sunderland Royal Hospital, Kayll Road, SunderlandSR4 7TP, UK E-mail: daniel.lin1@nhs.net
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Abstract

Objective

Wide-ranging outcomes have been reported for surgical and non-surgical management of T3 laryngeal carcinomas. This study compared the outcomes of T3 tumours treated with laryngectomy or (chemo)radiotherapy in the northeast of England.

Methods

The outcomes of T3 laryngeal carcinoma treatment at three centres (2007–2016) were retrospectively analysed using descriptive statistics and survival curves.

Results

Of 179 T3 laryngeal carcinomas, 68 were treated with laryngectomies, 57 with chemoradiotherapy and 32 with radiotherapy. There was no significant five-year survival difference between treatment with laryngectomy (34.1 per cent) and chemoradiotherapy (48.6 per cent) (p = 0.184). The five-year overall survival rate for radiotherapy (12.5 per cent) was significantly inferior compared to laryngectomy and chemoradiotherapy (p = 0.003 and p < 0.001, respectively). The recurrence rates were 22.1 per cent for laryngectomy, 17.5 per cent for chemoradiotherapy and 50 per cent for radiotherapy. There were significant differences in recurrence rates when laryngectomy (p = 0.005) and chemoradiotherapy (p = 0.001) were compared to radiotherapy.

Conclusion

Laryngectomy and chemoradiotherapy had significantly higher five-year overall survival and lower recurrence rates compared with radiotherapy alone. Laryngectomy should be considered in patients unsuitable for chemotherapy, as it may convey a significant survival advantage over radiotherapy alone.

Keywords

LarynxLaryngectomyOutcomes ResearchSurvival AnalysisHead And Neck Cancer
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 12 , December 2020 , pp. 1103 - 1107
Copyright
Copyright © JLO (1984) Limited, 2021

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Footnotes

Mr D Lin takes responsibility for the integrity of the content of the paper

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