Current Trends in Laryngeal Cancer Treatment

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 9371

Special Issue Editors


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Guest Editor
Department of Health Science, Otolaryngology, University of Catanzaro, 88100 Catanzaro, Italy
Interests: laryngeal disorders; laryngeal surgery; microsurgery; endoscopic surgery; open surgery; laser surgery
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Guest Editor
Sapienza Università di Roma, Roma, Italy
Interests: head and neck cancer; laryngeal surgery; oncology; chemotherapy

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Guest Editor
Department of Sense Organs, Sapienza University of Rome, 00186 Rome, Italy
Interests: audiology; vestibular disordes; hearing loss; tinnitus; head and neck cancer; laryngology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Laryngeal cancer represents 4.5% of all malignancies and is one of the most common cancers of the upper aerodigestive tract. Tumor biology, clinical behavior, and prognosis differ on the basis of its location and stage. Early and advanced glottic cancer can benefit from different modalities of treatment, including radiotherapy, transoral laser surgery, or open partial horizontal laryngectomy. However, the treatment of glottic cancer with the involvement of the anterior commissure remains controversial. In recent years, we have seen an increase in conservative surgery. This can be attributed to the improvement of diagnostic approaches. Clinical staging with the assistance of diagnostic imaging is the most important time of therapeutic planning, which should ensure oncological radicality. However, today, many patients still present with an advanced stage of disease and need a total laryngectomy. This surgical treatment has important psycho-physical and social consequences for the patient’s quality of life. This is due to the functional changes resulting from the removal of the larynx, which causes the immediate loss of phonatory function and altered respiratory physiology. Furthermore, there are different approaches for advanced laryngeal cancer with loco-regional metastatic disease and for recurrent disease. The debate about the ideal treatment modality of laryngeal cancer is old but still open. The purpose of this Special Issue is to focus attention on new diagnostic, prognostic, and therapeutic approaches to laryngeal cancer. We are pleased to invite you and your colleagues to submit your original research articles, meta-analyses, and review articles, providing an up-to-date overview of all aspects of the current trends in laryngeal cancer treatment.

Prof. Eugenia Allegra
Prof. Marco De Vincentiis
Prof. Massimo Ralli
Guest Editors

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Keywords

  • Laryngeal cancer
  • Early glottic cancer
  • Biomarkers
  • Transoral laser microsurgery
  • Open partial horizontal laryngectomy
  • Neck dissection
  • Transoral robotic surgery
  • Total laryngectomy
  • Phonatory rehabilitation
  • Respiratory rehabilitation

Published Papers (4 papers)

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Research

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10 pages, 1299 KiB  
Article
Role of Clinical-Demographic Data in Survival Rates of Advanced Laryngeal Cancer
by Eugenia Allegra, Maria Rita Bianco, Massimo Ralli, Antonio Greco, Diletta Angeletti and Marco de Vincentiis
Medicina 2021, 57(3), 267; https://doi.org/10.3390/medicina57030267 - 15 Mar 2021
Cited by 10 | Viewed by 1646
Abstract
Background and Objectives: Laryngeal cancer is one of the most common cancers in the upper aerodigestive tract, and tobacco and alcohol habits are the most relevant risk factors. The role of these risk factors in the incidence of laryngeal carcinomas is well [...] Read more.
Background and Objectives: Laryngeal cancer is one of the most common cancers in the upper aerodigestive tract, and tobacco and alcohol habits are the most relevant risk factors. The role of these risk factors in the incidence of laryngeal carcinomas is well known, yet only a few studies have been conducted on their role as risk factors of prognosis. The aim of the study was to assess the impact of clinical–demographic data on overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) in patients with advanced-stage laryngeal cancer (Stage III–IV) who underwent total laryngectomy. Materials and Methods: This retrospective study was carried out on patients with Stage III–IV laryngeal squamous cell carcinoma treated with total laryngectomy between 2004 and 2014. For each patient, clinical and anamnestic data were collected and collated in a database, including alcohol and smoking habits. Results: Considering the variable age, family history, alcohol, grading, subsite, stage, pT stage, pN stage, and adjuvant therapy, no statistical significance was found for five-year OS. Smoking was the only variable that was statistically significant (p = 0.0043). A relevant difference was noted in the five-year DFS between pN-negative and pN-positive tumors (74.3% vs. 55.26%, respectively; p = 0.056), and a statistically significant difference was found between non- and ≤20 cigarettes/day smokers and heavy smokers (77.78% vs. 53.66%, respectively; p = 0.021). The five-year disease-specific survival rate was 68.83%, and a significant difference was detected for the smoking and pN stage variables. Heavy smokers (43.90% died vs. 16.67% of the non- and ≤20 cigarettes/day smokers; p = 0.0057) and pN-positive (42.1% died vs. 20.51% of the pN-negative patients; p = 0.042) patients had a worse prognosis. Conclusion: Smoking in our study was found to be an important independent risk factor for worse OS and DSS in patients with advanced laryngeal cancer. Full article
(This article belongs to the Special Issue Current Trends in Laryngeal Cancer Treatment)
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9 pages, 953 KiB  
Article
Early Glottic Cancer Treated by Transoral Laser Surgery Using Toluidine Blue for the Definition of the Surgical Margins: A Pilot Study
by Eugenia Allegra, Maria Rita Bianco, Chiara Mignogna, Gaetano Davide Drago, Domenico Michele Modica and Lidia Puzzo
Medicina 2020, 56(7), 334; https://doi.org/10.3390/medicina56070334 - 3 Jul 2020
Cited by 3 | Viewed by 1961
Abstract
Background and objectives: Transoral laser microsurgery (TLM) is widely accepted for its advantages, which consist of a brief hospital stay, rapid functional recovery, low management costs and the fact that it can be easily repeated in cases of recurrence. However, a high [...] Read more.
Background and objectives: Transoral laser microsurgery (TLM) is widely accepted for its advantages, which consist of a brief hospital stay, rapid functional recovery, low management costs and the fact that it can be easily repeated in cases of recurrence. However, a high incidence of positive or narrow surgical margins has been reported in the literature, even if controversy still exists on the prognostic significance of positive resection margins. The aim of the study was to evaluate the utility of toluidine blue staining in defining the resection margins of early glottic cancer (T1a–T2) treated with TLM. Materials and Methods: This retrospective study was conducted on patients with early glottic cancer (T1a–T2) managed by TLM. A group of patients treated between 2010 and 2014 underwent toluidine blue staining (TB group) of the lesions before starting the cordectomy by TLM, and a group of patients treated by TLM between 2006 and 2009 was considered the control group. Results: A total of 44 subjects were included in this study: 41 were men, and 3 were women. The mean age was 58 ± 9.0 years (median 59.0, range 41–77). Twenty-three of the 44 patients were included in the TB group and 21 in the case control group. In the TB group, only the positivity of the deep margin was a predictor of local recurrence (p = 0.037), while in the control group, positive or close margins and the type of cordectomy were predictive factors of local recurrence (p = 0.049). Considering the TB group and control cases, the 5-year local recurrence-free survival was 95.6% and 80.9%, respectively (p = 0.14). Conclusions: From this first study, toluidine blue staining seems to be a useful modality to improve the rate of the negative resection margins of early glottic cancer (T1a–T2) treated by TLM. Full article
(This article belongs to the Special Issue Current Trends in Laryngeal Cancer Treatment)
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Review

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9 pages, 592 KiB  
Review
Obstructive Sleep Apnoea in Patients Treated for Head and Neck Cancer: A Systematic Review of the Literature
by Massimo Ralli, Flaminia Campo, Diletta Angeletti, Eugenia Allegra, Antonio Minni, Antonella Polimeni, Antonio Greco and Marco de Vincentiis
Medicina 2020, 56(8), 399; https://doi.org/10.3390/medicina56080399 - 8 Aug 2020
Cited by 15 | Viewed by 2848
Abstract
Background and objectives: Obstructive sleep apnoea (OSA) is clinically defined by signs of daytime sleepiness and objective measures of disordered breathing during sleep. The literature is still controversial on the incidence and aetiology of OSA secondary to head and neck cancer treatment. [...] Read more.
Background and objectives: Obstructive sleep apnoea (OSA) is clinically defined by signs of daytime sleepiness and objective measures of disordered breathing during sleep. The literature is still controversial on the incidence and aetiology of OSA secondary to head and neck cancer treatment. The aim of this systematic review is to evaluate and discuss the prevalence of OSA in patients treated with surgery and/or chemo/radiotherapy for head and neck cancer. Materials and methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was performed on May 2020 using the MEDLINE database, Scopus, and Google Scholar. The searches were conducted using combinations of the following terms: head and neck cancer, OSA, radiotherapy, chemotherapy, partial laryngectomy, laryngeal cancer, neoplasm, tumour, carcinoma, and oropharyngeal cancer. Results: Our results suggest that head and neck cancer patients have a higher incidence of OSA (59.78%) compared to the general population; differences may occur based on the type of treatment. Conclusions: Clinicians should recognise the higher prevalence of OSA in patients treated for head and neck cancer and should consider a comprehensive sleep history as part of the evaluation and management of these patients. Further research is needed to evaluate the exact prevalence, aetiology, and correct management of OSA after treatment for head and neck cancer. Full article
(This article belongs to the Special Issue Current Trends in Laryngeal Cancer Treatment)
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Other

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13 pages, 1414 KiB  
Case Report
Sarcomas of the Larynx: One Institution’s Experience and Treatment Protocol Analyses
by Jaromir Astl, Richard Holy, Inna Tuckova, Tomas Belsan, Miloslav Pala and Jan Rotnagl
Medicina 2021, 57(3), 192; https://doi.org/10.3390/medicina57030192 - 25 Feb 2021
Cited by 4 | Viewed by 2221
Abstract
Soft tissue sarcomas in the head and neck are rare malignancies. They occur in this area in less than 1% of all malignant tumors. Some authors have described the development of sarcoma from the mesenchymal tissue in the larynx. The histological diagnosis of [...] Read more.
Soft tissue sarcomas in the head and neck are rare malignancies. They occur in this area in less than 1% of all malignant tumors. Some authors have described the development of sarcoma from the mesenchymal tissue in the larynx. The histological diagnosis of a sarcoma depends on the immunohistochemical investigation. In particularly difficult diagnoses, electron microscopy has to be used. The treatment recommendation depends on the histological type of sarcoma. We analysed and summarized data on the diagnostic criteria and therapy for sarcoma of the larynx presented in the literature. We present three new cases of laryngeal sarcoma and describe the analyses of the published diagnostic and treatment schedules of laryngeal sarcomas. We developed a treatment protocol recommendation for laryngeal sarcoma based on an analysis of literature data and case reports. This recommendation is based on histological type, staging, grading, size, and survival data. Full article
(This article belongs to the Special Issue Current Trends in Laryngeal Cancer Treatment)
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