Larynx Organ Preservation in Patients with Hypopharyngeal-Laryngeal Cancer

摘要

Object: The therapeutic options for advanced laryngeal-hypopharyngeal cancer have broadened in the last decades, in the attempt to cure the cancer sparing laryngeal functions and to improve quality of life (functional surgery, chemo- radiotherapy, combined therapy). Methods: We propose a single-centre based retrospective study on the results of the treatment of larynx-hypopharynx cancer on the basis of the different therapies offered, focusing on advanced-stage cancers. Among 146 patients with laryngeal-hypopharyngeal cancer treated in the period 1999-2006, we focused on 64 patients with advanced stage resectable cancer. In the larynx cancer group ?n = 40-, 32 patients had surgery and 8 patients had CT-RT (refusal of laryngectomy or relative contraindications to surgery). In the hypopharynx cancer group ?n = 24-, 16 patients underwent surgery and 8 patients had CT-RT. The outcome measure considered has been overall survival. Results: Larynx cancer group. Overall survival: after surgery we observed a 3-year survival of 62%, and a 5-year survival of 44%, while after CT-RT we had a 3-year survival of 25% and a 5-year survival of 12%. Hypopharynx cancer group. Overall survival: surgery: 3-year survival: 40%, 5-year survival 32%;CT-RT: 3-year survival: 50%, 5-year survival: 34%. Conclusion: The results emphasize the use of larynx-preserving approaches for appropriately selected patients without a compromise in survival;in our case series, surgery had better outcome than CT-RT in advanced-stage larynx cancer;whilst no significant differences were observed in the treatment of hypopharynx cancer.