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Open Partial Horizontal Laryngectomies for T3–T4 Laryngeal Cancer: Prognostic Impact of Anterior vs. Posterior Laryngeal Compartmentalization
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Cancers 2019, 11(3), 360; https://doi.org/10.3390/cancers11030360

Arytenoid Fixation in Laryngeal Cancer: Radiological Pictures and Clinical Correlations with Respect to Conservative Treatments

1
Head and Neck Oncology Service, Candiolo Cancer Institute—FPO IRCCS, 10060 Candiolo (TO), Italy
2
Department of Oncology, University of Turin, 10043 Orbassano (TO), Italy
3
Radiology Unit, Mauriziano Umberto I Hospital, 10128 Turin, Italy
4
Radiology Unit, Surgery Department, Candiolo Cancer Institute, FPO—IRCCS, 10060 Candiolo (TO), Italy
5
Pathology Unit, Medicine Department, Candiolo Cancer Institute, FPO—IRCCS, 10060 Candiolo (TO), Italy
6
Department of Diagnostic Imaging, San Luigi Gonzaga Hospital, University of Turin, 10043 Orbassano (TO), Italy
7
Department of Oncology, Division of Pathology, San Luigi Gonzaga Hospital, University of Turin, 10043 Orbassano (TO), Italy
8
Otorhinolaryngology Unit, University of Turin, 10124 Turin, Italy
9
Department of Clinical and Biological Sciences, University of Turin, 10043 Orbassano (TO), Italy
*
Author to whom correspondence should be addressed.
Received: 19 January 2019 / Revised: 20 February 2019 / Accepted: 1 March 2019 / Published: 13 March 2019
(This article belongs to the Special Issue Emerging Concepts in Treatment of Laryngeal Cancer)
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Abstract

Background: The aim of this retrospective study was to identify different radiological features in intermediate–advanced laryngeal cancer (LC) associated with arytenoid fixation, in order to differentiate cases still safely amenable to conservative treatment by partial laryngectomy or chemoradiotherapy. Methods: 29 consecutive patients who underwent open partial horizontal laryngectomies (OPHLs), induction chemotherapy followed by radiotherapy in the case of >50% response (IC + RT) or total laryngectomy were classified as: pattern I (supraglottic LC fixing the arytenoid due to weight effect), pattern II (glottic LC involving the posterior paraglottic space and spreading toward the crico-arytenoid joint and infraglottic extension <10 mm), pattern III (glottic—infraglottic LC involving the crico-arytenoid joint and infraglottic extension >10 mm) and pattern IV (transglottic and infraglottic LC with massive crico-arytenoid unit involvement, reaching the hypopharyngeal submucosa). All glottic cancers treated with surgery were studied by a cross sectional approach. Results: A substantial agreement between the work-up and the pathology results has been obtained in each of the subcategories. Three-year disease-free survivals, local control and freedom from laryngectomy were significantly better in pattern II compared to pattern III–IV. Conclusions: LC showing fixed arytenoid due to weight effect or posterior paraglottic space involvement with infraglottic extension <10 mm assessed at the true vocal cord midline are still safely manageable by OPHL or IC + RT. View Full-Text
Keywords: open partial horizontal laryngectomy; supracricoid partial laryngectomy; supratracheal partial laryngectomy; T3 laryngeal cancer; laryngeal cancer; fixed arytenoid open partial horizontal laryngectomy; supracricoid partial laryngectomy; supratracheal partial laryngectomy; T3 laryngeal cancer; laryngeal cancer; fixed arytenoid
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Succo, G.; Cirillo, S.; Bertotto, I.; Maldi, E.; Balmativola, D.; Petracchini, M.; Gned, D.; Fornari, A.; Motatto, G.M.; Sprio, A.E.; Manca, A.; Crosetti, E. Arytenoid Fixation in Laryngeal Cancer: Radiological Pictures and Clinical Correlations with Respect to Conservative Treatments. Cancers 2019, 11, 360.

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