Comparison of Current Surgical and Non-Surgical Treatment Strategies for Early and Locally Advanced Stage Glottic Laryngeal Cancer and Their Outcome
Abstract
:1. Introduction
2. Early Stage Glottic Laryngeal Cancer
2.1. T1N0
2.1.1. Oncologic Outcome
2.1.2. Voice Quality and Laryngeal Preservation
2.2. T2N0
2.2.1. Oncologic Outcome
2.2.2. Voice Quality and Laryngeal Preservation
2.3. Anterior Commissure Involvement
3. Locally Advanced Stage Glottic Laryngeal Cancer
3.1. Overall UICC Stage III–IV
3.2. T3N0-3
3.2.1. Oncologic Outcome
3.2.2. Laryngeal Preservation and Functional Outcome
3.3. T4aN0-3
3.3.1. Oncologic Outcome
3.3.2. Laryngeal Preservation and Functional Outcome
4. Summary
5. Conclusions
Funding
Conflicts of Interest
References
- Megwalu, U.C.; Sikora, A.G. Survival outcomes in advanced laryngeal cancer. JAMA Otolaryngol. Head Neck Surg. 2014, 140, 855–860. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Torre, L.A.; Bray, F.; Siegel, R.L.; Ferlay, J.; Lortet-Tieulent, J.; Jemal, A. Global cancer statistics, 2012. CA Cancer J. Clin. 2015, 65, 87–108. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- National Cancer Institute. SEER: Cancer Stat Facts: Larynx Cancer. 2016. Available online: http://seer.cancer.gov/statfacts/html/laryn.html (accessed on 13 September 2019).
- Kernan, J.D. Malignancies of the larynx; shall we employ surgery or radiotherapy? Med. Rec. 1946, 159, 351. [Google Scholar] [PubMed]
- Osborn, H.A.; Hu, A.; Venkatesan, V.; Nichols, A.; Franklin, J.H.; Yoo, J.H.; Ceron, M.; Whelan, F.; Fung, K. Comparison of endoscopic laser resection versus radiation therapy for the treatment of early glottic carcinoma. J. Otolaryngol. Head Neck Surg. 2011, 40, 200–204. [Google Scholar] [PubMed]
- Cömert, E.; Tunçel, Ü.; Dizman, A.; Güney, Y.Y. Comparison of early oncological results of diode laser surgery with radiotherapy for early glottic carcinoma. Otolaryngol. Head Neck Surg. 2014, 150, 818–823. [Google Scholar] [CrossRef]
- Higgins, K.M. What treatment for early-stage glottic carcinoma among adult patients: CO2 endolaryngeal laser excision versus standard fractionated external beam radiation is superior in terms of cost utility? Laryngoscope 2011, 121, 116–134. [Google Scholar] [CrossRef]
- Abdurehim, Y.; Hua, Z.; Yasin, Y.; Xukurhan, A.; Imam, I.; Yuqin, F. Transoral laser surgery versus radiotherapy: Systematic review and meta-analysis for treatment options of T1a glottic cancer. Head Neck 2012, 34, 23–33. [Google Scholar] [CrossRef]
- Warner, L.; Chudasama, J.; Kelly, C.G.; Loughran, S.; McKenzie, K.; Wight, R.; Dey, P. Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer. Cochrane Database Syst. Rev. 2014, 12, CD002027. [Google Scholar] [CrossRef] [Green Version]
- Huang, G.; Luo, M.; Zhang, J.; Liu, H. Laser surgery versus radiotherapy for T1a glottic carcinoma: A meta-analysis of oncologic outcomes. Acta Otolaryngol. 2017, 137, 1204–1209. [Google Scholar] [CrossRef]
- Mo, H.-L.; Li, J.; Yang, X.; Zhang, F.; Xiong, J.-W.; Yang, Z.-L.; Tan, J.; Li, B. Transoral laser microsurgery versus radiotherapy for T1 glottic carcinoma: A systematic review and meta-analysis. Lasers Med. Sci. 2017, 32, 461–467. [Google Scholar] [CrossRef]
- Vaculik, M.F.; MacKay, C.A.; Taylor, S.M.; Trites, J.R.B.; Hart, R.D.; Rigby, M.H. Systematic review and meta-analysis of T1 glottic cancer outcomes comparing CO2 transoral laser microsurgery and radiotherapy. J. Otolaryngol. Head Neck Surg. 2019, 48, 44. [Google Scholar] [CrossRef] [PubMed]
- Gioacchini, F.M.; Tulli, M.; Kaleci, S.; Bondi, S.; Bussi, M.; Re, M. Therapeutic modalities and oncologic outcomes in the treatment of T1b glottic squamous cell carcinoma: A systematic review. Eur. Arch. Otorhinolaryngol. 2017, 274, 4091–4102. [Google Scholar] [CrossRef] [PubMed]
- Harwood, A.R.; Rawlinson, E. The quality of life of patients following treatment for laryngeal cancer. Int. J. Radiat. Oncol. Biol. Phys. 1983, 9, 335–338. [Google Scholar] [CrossRef]
- Remmelts, A.J.; Hoebers, F.J.P.; Klop, W.M.C.; Balm, A.J.M.; Hamming-Vrieze, O.; van den Brekel, M.W.M. Evaluation of lasersurgery and radiotherapy as treatment modalities in early stage laryngeal carcinoma: Tumour outcome and quality of voice. Eur. Arch. Otorhinolaryngol. 2013, 270, 2079–2087. [Google Scholar] [CrossRef] [PubMed]
- Low, T.H.H.; Yeh, D.; Zhang, T.; Araslanova, R.; Hammond, J.A.; Palma, D.; Read, N.; Venkatesan, V.; MacNeil, S.D.; Yoo, J.; et al. Evaluating organ preservation outcome as treatment endpoint for T1aN0 glottic cancer. Laryngoscope 2017, 127, 1322–1327. [Google Scholar] [CrossRef]
- Kono, T.; Saito, K.; Yabe, H.; Uno, K.; Ogawa, K. Comparative multidimensional assessment of laryngeal function and quality of life after radiotherapy and laser surgery for early glottic cancer. Head Neck 2016, 38, 1085–1090. [Google Scholar] [CrossRef]
- Taylor, S.M.; Kerr, P.; Fung, K.; Aneeshkumar, M.K.; Wilke, D.; Jiang, Y.; Scott, J.; Phillips, J.; Hart, R.D.; Trites, J.R.B.; et al. Treatment of T1b glottic SCC: Laser vs. Radiation—A Canadian multicenter study. J. Otolaryngol. Head Neck Surg. 2013, 42, 22. [Google Scholar] [CrossRef] [Green Version]
- Alkan, U.; Nachalon, Y.; Shkedy, Y.; Yaniv, D.; Shvero, J.; Popovtzer, A. T1 squamous cell carcinoma of the glottis with anterior commissure involvement: Radiotherapy versus transoral laser microsurgery. Head Neck 2017, 39, 1101–1105. [Google Scholar] [CrossRef]
- Kujath, M.; Kerr, P.; Myers, C.; Bammeke, F.; Lambert, P.; Cooke, A.; Sutherland, D. Functional outcomes and laryngectomy-free survival after transoral CO₂ laser microsurgery for stage 1 and 2 glottic carcinoma. J. Otolaryngol. Head Neck Surg. 2011, 40, S49–S58. [Google Scholar]
- Tomifuji, M.; Araki, K.; Niwa, K.; Miyagawa, Y.; Mizokami, D.; Kitagawa, Y.; Yamashita, T.; Matsunobu, T.; Shiotani, A. Comparison of voice quality after laser cordectomy with that after radiotherapy or chemoradiotherapy for early glottic carcinoma. ORL J. Otorhinolaryngol. Relat. Spec. 2013, 75, 18–26. [Google Scholar] [CrossRef]
- Shelan, M.; Anschuetz, L.; Schubert, A.D.; Bojaxhiu, B.; Dal Pra, A.; Behrensmeier, F.; Aebersold, D.M.; Giger, R.; Elicin, O. T1-2 glottic cancer treated with radiotherapy and/or surgery. Strahlenther. Onkol. 2017, 193, 995–1004. [Google Scholar] [CrossRef] [PubMed]
- Ogol’tsova, E.S.; Paches, A.I.; Matiakin, E.G.; Dvoírin, V.V.; Fedotenko, S.P.; Alferov, V.S.; Boikov, V.P.; Alekseeva, S.I.; Ol’shanskii, V.O.; Stiop, L.D. Comparative evaluation of the effectiveness of radiotherapy, surgery and combined treatment of stage I-II laryngeal cancer (T1-2NoMo) based on the data of a cooperative randomized study. Vestn. Otorinolaringol. 1990, 3, 3–7. [Google Scholar]
- Aaltonen, L.-M.; Rautiainen, N.; Sellman, J.; Saarilahti, K.; Mäkitie, A.; Rihkanen, H.; Laranne, J.; Kleemola, L.; Wigren, T.; Sala, E.; et al. Voice quality after treatment of early vocal cord cancer: A randomized trial comparing laser surgery with radiation therapy. Int. J. Radiat. Oncol. Biol. Phys. 2014, 90, 255–260. [Google Scholar] [CrossRef] [PubMed]
- Greulich, M.T.; Parker, N.P.; Lee, P.; Merati, A.L.; Misono, S. Voice outcomes following radiation versus laser microsurgery for T1 glottic carcinoma: Systematic review and meta-analysis. Otolaryngol. Head. Neck Surg. 2015, 152, 811–819. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cohen, S.M.; Garrett, C.G.; Dupont, W.D.; Ossoff, R.H.; Courey, M.S. Voice-related quality of life in T1 glottic cancer: Irradiation versus endoscopic excision. Ann. Otol. Rhinol. Laryngol. 2006, 115, 581–586. [Google Scholar] [CrossRef] [PubMed]
- Du, G.; Liu, C.; Yu, W.; Li, J.; Li, W.; Wang, C.; Zhu, J. Voice outcomes after laser surgery vs. radiotherapy of early glottic carcinoma: A meta-analysis. Int. J. Clin. Exp. Med. 2015, 8, 17206–17213. [Google Scholar]
- Strieth, S.; Ernst, B.P.; Both, I.; Hirth, D.; Pfisterer, L.N.; Künzel, J.; Eder, K. Randomized controlled single-blinded clinical trial of functional voice outcome after vascular targeting KTP laser microsurgery of early laryngeal cancer. Head Neck 2019, 41, 899–907. [Google Scholar] [CrossRef] [Green Version]
- Chera, B.S.; Amdur, R.J.; Morris, C.G.; Mendenhall, W.M. Carotid-sparing intensity-modulated radiotherapy for early-stage squamous cell carcinoma of the true vocal cord. Int. J. Radiat. Oncol. Biol. Phys. 2010, 77, 1380–1385. [Google Scholar] [CrossRef]
- Ermiş, E.; Teo, M.; Dyker, K.E.; Fosker, C.; Sen, M.; Prestwich, R.J. Definitive hypofractionated radiotherapy for early glottic carcinoma: Experience of 55Gy in 20 fractions. Radiat. Oncol. 2015, 10, 203. [Google Scholar] [CrossRef] [Green Version]
- Yamazaki, H.; Nishiyama, K.; Tanaka, E.; Koizumi, M.; Chatani, M. Radiotherapy for early glottic carcinoma (T1N0M0): Results of prospective randomized study of radiation fraction size and overall treatment time. Int. J. Radiat. Oncol. Biol. Phys. 2006, 64, 77–82. [Google Scholar] [CrossRef]
- Moon, S.H.; Cho, K.H.; Chung, E.J.; Lee, C.G.; Lee, K.C.; Chai, G.-Y.; Kang, K.M.; Lee, J.Y.; Chung, W.-K.; Park, W.Y.; et al. A prospective randomized trial comparing hypofractionation with conventional fractionation radiotherapy for T1-2 glottic squamous cell carcinomas: Results of a Korean Radiation Oncology Group (KROG-0201) study. Radiother. Oncol. 2013, 110, 98–103. [Google Scholar] [CrossRef]
- Kodaira, T.; Kagami, Y.; Shibata, T.; Shikama, N.; Nishimura, Y.; Ishikura, S.; Nakamura, K.; Saito, Y.; Matsumoto, Y.; Teshima, T.; et al. Results of a multi-institutional, randomized, non-inferiority, phase III trial of accelerated fractionation versus standard fractionation in radiation therapy for T1-2N0M0 glottic cancer: Japan Clinical Oncology Group Study (JCOG0701). Ann. Oncol. Off. J. Eur. Soc. Med. Oncol. 2018, 29, 992–997. [Google Scholar] [CrossRef] [PubMed]
- Lyhne, N.M.; Primdahl, H.; Kristensen, C.A.; Andersen, E.; Johansen, J.; Andersen, L.J.; Evensen, J.; Mortensen, H.R.; Overgaard, J. The DAHANCA 6 randomized trial: Effect of 6 vs 5 weekly fractions of radiotherapy in patients with glottic squamous cell carcinoma. Radiother. Oncol. 2015, 117, 91–98. [Google Scholar] [CrossRef] [PubMed]
- Al-Mamgani, A.; Kwa, S.L.S.; Tans, L.; Moring, M.; Fransen, D.; Mehilal, R.; Verduijn, G.M.; Baatenburg de Jong, R.J.; Heijmen, B.J.M.; Levendag, P.C. Single Vocal Cord Irradiation: Image Guided Intensity Modulated Hypofractionated Radiation Therapy for T1a Glottic Cancer: Early Clinical Results. Int. J. Radiat. Oncol. Biol. Phys. 2015, 93, 337–343. [Google Scholar] [CrossRef] [PubMed]
- Rusthoven, K.; Chen, C.; Raben, D.; Kavanagh, B. Use of External Beam Radiotherapy Is Associated With Reduced Incidence of Second Primary Head and Neck Cancer: A SEER Database Analysis. Int. J. Radiat. Oncol. Biol. Phys. 2008, 71, 192–198. [Google Scholar] [CrossRef]
- Farhadieh, R.D.; Rees, C.G.G.; Yang, J.L.; Salardini, A.; Russell, P.; Smee, R. Radiotherapy in Larynx Squamous Cell Carcinoma is not Associated with an Increased Diagnosis of Second Primary Tumours. Clin. Oncol. 2009, 21, 315–319. [Google Scholar] [CrossRef]
- Rigby, M.H.; Reynolds, L.F.; Hart, R.D.; Trites, J.R.B.; Brown, T.; Mark Taylor, S. T2 glottic carcinoma: Analysis of recurrences in 36 cases undergoing primary transoral laser microsurgery resection. J. Otolaryngol. Head Neck Surg. 2012, 41, S85–S89. [Google Scholar]
- Fang, T.-J.; Courey, M.S.; Liao, C.-T.; Yen, T.-C.; Li, H.-Y. Frozen margin analysis as a prognosis predictor in early glottic cancer by laser cordectomy. Laryngoscope 2013, 123, 1490–1495. [Google Scholar] [CrossRef]
- Breda, E.; Catarino, R.; Monteiro, E. Transoral laser microsurgery for laryngeal carcinoma: Survival analysis in a hospital-based population. Head Neck 2015, 37, 1181–1186. [Google Scholar] [CrossRef]
- Hoffmann, C.; Cornu, N.; Hans, S.; Sadoughi, B.; Badoual, C.; Brasnu, D. Early glottic cancer involving the anterior commissure treated by transoral laser cordectomy. Laryngoscope 2016, 126, 1817–1822. [Google Scholar] [CrossRef]
- Ansarin, M.; Cattaneo, A.; De Benedetto, L.; Zorzi, S.; Lombardi, F.; Alterio, D.; Rocca, M.C.; Scelsi, D.; Preda, L.; Chiesa, F.; et al. Retrospective analysis of factors influencing oncologic outcome in 590 patients with early-intermediate glottic cancer treated by transoral laser microsurgery. Head Neck 2017, 39, 71–81. [Google Scholar] [CrossRef]
- Lucioni, M.; Marioni, G.; Bertolin, A.; Giacomelli, L.; Rizzotto, G. Glottic laser surgery: Outcomes according to 2007 ELS classification. Eur. Arch. Otorhinolaryngol. 2011, 268, 1771–1778. [Google Scholar] [CrossRef] [PubMed]
- Douglas, C.M.; Bernstein, J.M.; Ormston, V.E.; Hall, R.C.; Merve, A.; Swindell, R.; Valentine, H.R.; Slevin, N.J.; West, C.M.L.; Homer, J.J. Lack of prognostic effect of carbonic anhydrase-9, hypoxia inducible factor-1α and bcl-2 in 286 patients with early squamous cell carcinoma of the glottic larynx treated with radiotherapy. Clin. Oncol. 2013, 25, 59–65. [Google Scholar] [CrossRef] [PubMed]
- Karasawa, K.; Kunogi, H.; Hirai, T.; Hoji, H.; Hirowatari, H.; Izawa, H.; Ito, K.; Sasai, K.; Furuya, T.; Ozawa, S.; et al. Radiotherapy with fraction size of 2.25 Gy in T1-2 laryngeal and hypopharyngeal cancer. J. Radiat. Res. 2013, 54, 684–689. [Google Scholar] [CrossRef]
- Hoebers, F.; Rios, E.; Troost, E.; van den Ende, P.; Kross, K.; Lacko, M.; Lalisang, R.; Kremer, B.; de Jong, J. Definitive radiation therapy for treatment of laryngeal carcinoma: Impact of local relapse on outcome and implications for treatment strategies. Strahlentherapie und Onkologie 2013, 189, 834–841. [Google Scholar] [CrossRef] [PubMed]
- Motegi, A.; Kawashima, M.; Arahira, S.; Zenda, S.; Toshima, M.; Onozawa, M.; Hayashi, R.; Akimoto, T. Accelerated radiotherapy for T1 to T2 glottic cancer. Head Neck 2015, 37, 579–584. [Google Scholar] [CrossRef] [PubMed]
- Higashino, M.; Kawata, R.; Lee, K.; Nishikawa, S.; Ichihara, S.; Uesugi, Y. Radiotherapy concurrent with S-1 and radiotherapy alone for T2N0 glottic carcinoma: A retrospective comparative study. Auris Nasus Larynx 2014, 41, 364–368. [Google Scholar] [CrossRef] [PubMed]
- Potenza, I.; Franco, P.; Moretto, F.; Badellino, S.; Balcet, V.; Rossi, G.; Landolfo, V.; Riva, G.; Pecorari, G.; Ragona, R.; et al. Exclusive Radiotherapy for Early-stage Glottic Cancer: A Single-institution Retrospective Analysis with a Focus on Voice Quality. Anticancer Res. 2015, 35, 4155–4160. [Google Scholar]
- Warner, L.; Lee, K.; Homer, J.J. Transoral laser microsurgery versus radiotherapy for T2 glottic squamous cell carcinoma: A systematic review of local control outcomes. Clin. Otolaryngol. 2017, 42, 629–636. [Google Scholar] [CrossRef]
- Succo, G.; Crosetti, E.; Bertolin, A.; Lucioni, M.; Caracciolo, A.; Panetta, V.; Sprio, A.E.; Berta, G.N.; Rizzotto, G. Benefits and drawbacks of open partial horizontal laryngectomies, Part A: Early- to intermediate-stage glottic carcinoma. Head Neck 2016, 38, E333–E340. [Google Scholar] [CrossRef] [Green Version]
- Rizzotto, G.; Crosetti, E.; Lucioni, M.; Bertolin, A.; Monticone, V.; Sprio, A.E.; Berta, G.N.; Succo, G. Oncologic outcomes of supratracheal laryngectomy: Critical analysis. Head Neck 2015, 37, 1417–1424. [Google Scholar] [CrossRef] [PubMed]
- Hartl, D.M.; Ferlito, A.; Brasnu, D.F.; Langendijk, J.A.; Rinaldo, A.; Silver, C.E.; Wolf, G.T. Evidence-based review of treatment options for patients with glottic cancer. Head Neck 2011, 33, 1638–1648. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Galli, A.; Giordano, L.; Sarandria, D.; Di Santo, D.; Bussi, M. Oncological and complication assessment of CO2 laser-assisted endoscopic surgery for T1-T2 glottic tumours: Clinical experience. Acta Otorhinolaryngol. Ital. 2016, 36, 167–173. [Google Scholar] [PubMed]
- Sachse, F.; Stoll, W.; Rudack, C. Evaluation of treatment results with regard to initial anterior commissure involvement in early glottic carcinoma treated by external partial surgery or transoral laser microresection. Head Neck 2009, 31, 531–537. [Google Scholar] [CrossRef]
- Chone, C.T.; Yonehara, E.; Martins, J.E.F.; Altemani, A.; Crespo, A.N. Importance of anterior commissure in recurrence of early glottic cancer after laser endoscopic resection. Arch. Otolaryngol. Head Neck Surg. 2007, 133, 882–887. [Google Scholar] [CrossRef] [Green Version]
- Hakeem, A.H.; Tubachi, J.; Pradhan, S.A. Significance of anterior commissure involvement in early glottic squamous cell carcinoma treated with trans-oral CO2 laser microsurgery. Laryngoscope 2013, 123, 1912–1917. [Google Scholar] [CrossRef]
- Laccourreye, O.; Muscatello, L.; Laccourreye, L.; Naudo, P.; Brasnu, D.; Weinstein, G. Supracricoid partial laryngectomy with cricohyoidoepiglottopexy for “early” glottic carcinoma classified as T1-T2N0 invading the anterior commissure. Am. J. Otolaryngol. 1997, 18, 385–390. [Google Scholar] [CrossRef]
- Atallah, I.; Berta, E.; Coffre, A.; Villa, J.; Reyt, E.; Righini, C.A. Supracricoid partial laryngectomy with crico-hyoido-epiglottopexy for glottic carcinoma with anterior commissure involvement. Acta Otorhinolaryngol. Ital. 2017, 37, 188–194. [Google Scholar]
- Allegra, E.; Saita, V.; Azzolina, A.; De Natale, M.; Bianco, M.R.; Modica, D.M.; Garozzo, A. Impact of the anterior commissure involvement on the survival of early glottic cancer treated with cricohyoidoepiglottopexy: A retrospective study. Cancer Manag. Res. 2018, 10, 5553–5558. [Google Scholar] [CrossRef] [Green Version]
- Cellai, E.; Frata, P.; Magrini, S.M.; Paiar, F.; Barca, R.; Fondelli, S.; Polli, C.; Livi, L.; Bonetti, B.; Vitali, E.; et al. Radical radiotherapy for early glottic cancer: Results in a series of 1087 patients from two Italian radiation oncology centers. I. The case of T1N0 disease. Int. J. Radiat. Oncol. Biol. Phys. 2005, 63, 1378–1386. [Google Scholar] [CrossRef]
- Elicin, O.; Ermiş, E.; Oehler, C.; Aebersold, D.M.; Caparrotti, F.; Zimmermann, F.; Studer, G.; Henke, G.; Adam, L.; Anschuetz, L.; et al. Influencing Factors on Radiotherapy Outcome in Stage I-II Glottic Larynx Cancer-A Multicenter Study. Front. Oncol. 2019, 9, 932. [Google Scholar] [CrossRef] [PubMed]
- Smee, R.I.; Meagher, N.S.; Williams, J.R.; Broadley, K.; Bridger, G.P. Role of radiotherapy in early glottic carcinoma. Head Neck 2010, 32, 850–859. [Google Scholar] [CrossRef] [PubMed]
- Marshak, G.G.; Brenner, B.; Shvero, J.; Shapira, J.; Ophir, D.; Hochman, I.; Marshak, G.G.; Sulkes, A.; Rakowsky, E. Prognostic factors for local control of early glottic cancer: The Rabin Medical Center retrospective study on 207 patients. Int. J. Radiat. Oncol. Biol. Phys. 1999, 43, 1009–1013. [Google Scholar] [CrossRef]
- Garden, A.S.; Forster, K.; Wong, P.F.; Morrison, W.H.; Schechter, N.R.; Ang, K.K. Results of radiotherapy for T2N0 glottic carcinoma: Does the “2” stand for twice-daily treatment? Int. J. Radiat. Oncol. Biol. Phys. 2003, 55, 322–328. [Google Scholar] [CrossRef]
- Lefebvre, J.L.; Rolland, F.; Tesselaar, M.; Bardet, E.; Leemans, C.R.; Geoffrois, L.; Hupperets, P.; Barzan, L.; de Raucourt, D.; Chevalier, D.; et al. Phase 3 randomized trial on larynx preservation comparing sequential vs alternating chemotherapy and radiotherapy. J. Natl. Cancer Inst. 2009, 101, 142–152. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Forastiere, A.A.; Goepfert, H.; Maor, M.; Pajak, T.F.; Weber, R.; Morrison, W.; Glisson, B.; Trotti, A.; Ridge, J.A.; Chao, C.; et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N. Engl. J. Med. 2003, 349, 2091–2098. [Google Scholar] [CrossRef] [Green Version]
- Department of Veterans Affairs Laryngeal Cancer Study Group; Wolf, G.T.; Fisher, S.G.; Hong, W.K.; Hillman, R.; Spaulding, M.; Laramore, G.E.; Endicott, J.W.; McClatchey, K.; Henderson, W.G. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N. Engl. J. Med. 1991, 324, 1685–1690. [Google Scholar]
- Terrell, J.E.; Fisher, S.G.; Wolf, G.T. Long-term quality of life after treatment of laryngeal cancer. The Veterans Affairs Laryngeal Cancer Study Group. Arch. Otolaryngol. Head Neck Surg. 1998, 124, 964–971. [Google Scholar] [CrossRef] [Green Version]
- Hoffman, H.T.; Porter, K.; Karnell, L.H.; Cooper, J.S.; Weber, R.S.; Langer, C.J.; Ang, K.-K.; Gay, G.; Stewart, A.; Robinson, R.A. Laryngeal cancer in the United States: Changes in demographics, patterns of care, and survival. Laryngoscope 2006, 116, 1–13. [Google Scholar] [CrossRef] [Green Version]
- Olsen, K.D. Reexamining the treatment of advanced laryngeal cancer. Head Neck 2010, 32, 1–7. [Google Scholar] [CrossRef]
- Lefebvre, J.-L.; Ang, K.K. Larynx Preservation Consensus Panel Larynx preservation clinical trial design: Key issues and recommendations-a consensus panel summary. Int. J. Radiat. Oncol. Biol. Phys. 2009, 73, 1293–1303. [Google Scholar] [CrossRef] [PubMed]
- Forastiere, A.A.; Zhang, Q.; Weber, R.S.; Maor, M.H.; Goepfert, H.; Pajak, T.F.; Morrison, W.; Glisson, B.; Trotti, A.; Ridge, J.A.; et al. Long-term results of RTOG 91-11: A comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J. Clin. Oncol. 2013, 31, 845–852. [Google Scholar] [CrossRef] [PubMed]
- Licitra, L.; Bonomo, P.; Sanguineti, G.; Bacigalupo, A.; Baldi, G.G.; Valerini, S.; Bruzzi, P. Different View on Larynx Preservation Evidence-Based Treatment Recommendations. J. Clin. Oncol. 2018, 36, 1376–1377. [Google Scholar] [CrossRef] [PubMed]
- Forastiere, A.A.; Fisher, S.G.; Wolf, G.T. Reply to L. Licitra et al. J. Clin. Oncol. 2018, 36, 1377–1378. [Google Scholar] [CrossRef]
- Posner, M.R.; Hershock, D.M.; Blajman, C.R.; Mickiewicz, E.; Winquist, E.; Gorbounova, V.; Tjulandin, S.; Shin, D.M.; Cullen, K.; Ervin, T.J.; et al. Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. N. Engl. J. Med. 2007, 357, 1705–1715. [Google Scholar] [CrossRef] [Green Version]
- Vermorken, J.B.; Remenar, E.; van Herpen, C.; Gorlia, T.; Mesia, R.; Degardin, M.; Stewart, J.S.; Jelic, S.; Betka, J.; Preiss, J.H.; et al. Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. N. Engl. J. Med. 2007, 357, 1695–1704. [Google Scholar] [CrossRef] [Green Version]
- Pointreau, Y.; Garaud, P.; Chapet, S.; Sire, C.; Tuchais, C.; Tortochaux, J.; Faivre, S.; Guerrif, S.; Alfonsi, M.; Calais, G. Randomized trial of induction chemotherapy with cisplatin and 5-fluorouracil with or without docetaxel for larynx preservation. J. Natl. Cancer Inst. 2009, 101, 498–506. [Google Scholar] [CrossRef] [Green Version]
- Fung, K.; Lyden, T.H.; Lee, J.; Urba, S.G.; Worden, F.; Eisbruch, A.; Tsien, C.; Bradford, C.R.; Chepeha, D.B.; Hogikyan, N.D.; et al. Voice and swallowing outcomes of an organ-preservation trial for advanced laryngeal cancer. Int. J. Radiat. Oncol. Biol. Phys. 2005, 63, 1395–1399. [Google Scholar] [CrossRef]
- Urba, S.; Wolf, G.; Eisbruch, A.; Worden, F.; Lee, J.; Bradford, C.; Teknos, T.; Chepeha, D.; Prince, M.; Hogikyan, N.; et al. Single-cycle induction chemotherapy selects patients with advanced laryngeal cancer for combined chemoradiation: A new treatment paradigm. J. Clin. Oncol. 2006, 24, 593–598. [Google Scholar] [CrossRef]
- Dietz, A.; Wichmann, G.; Kuhnt, T.; Pfreundner, L.; Hagen, R.; Scheich, M.; Kölbl, O.; Hautmann, M.G.; Strutz, J.; Schreiber, F.; et al. Induction chemotherapy (IC) followed by radiotherapy (RT) versus cetuximab plus IC and RT in advanced laryngeal/hypopharyngeal cancer resectable only by total laryngectomy-final results of the larynx organ preservation trial DeLOS-II. Ann. Oncol. Off. J. Eur. Soc. Med. Oncol. 2018, 29, 2105–2114. [Google Scholar] [CrossRef]
- Putten, L.; Bree, R.; Doornaert, P.A.; Buter, J.; Eerenstein, S.E.J.; Rietveld, D.H.F.; Kuik, D.J.; Leemans, C.R. Salvage surgery in post-chemoradiation laryngeal and hypopharyngeal carcinoma: Outcome and review. Acta Otorhinolaryngol. Ital. 2015, 35, 162–172. [Google Scholar]
- Aires, F.T.; Dedivitis, R.A.; Castro, M.A.F.; Bernardo, W.M.; Cernea, C.R.; Brandão, L.G. Efficacy of stapler pharyngeal closure after total laryngectomy: A systematic review. Head Neck 2014, 36, 739–742. [Google Scholar] [CrossRef] [PubMed]
- Khan, N.A.; Medina, J.E.; Sanclement, J.A.; Krempl, G.A. Fistula rates after salvage laryngectomy: Comparing pectoralis myofascial and myocutaneous flaps. Laryngoscope 2014, 124, 1615–1617. [Google Scholar] [CrossRef] [PubMed]
- Withrow, K.P.; Rosenthal, E.L.; Gourin, C.G.; Peters, G.E.; Magnuson, J.S.; Terris, D.J.; Carroll, W.W. Free tissue transfer to manage salvage laryngectomy defects after organ preservation failure. Laryngoscope 2007, 117, 781–784. [Google Scholar] [CrossRef] [PubMed]
- Sherman, E.J.; Fisher, S.G.; Kraus, D.H.; Zelefsky, M.J.; Seshan, V.E.; Singh, B.; Shaha, A.R.; Shah, J.P.; Wolf, G.T.; Pfister, D.G. TALK score: Development and validation of a prognostic model for predicting larynx preservation outcome. Laryngoscope 2012, 122, 1043–1050. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Wichmann, G.; Krüger, A.; Boehm, A.; Kolb, M.; Hofer, M.; Fischer, M.; Müller, S.; Purz, S.; Stumpp, P.; Sabri, O.; et al. Induction chemotherapy followed by radiotherapy for larynx preservation in advanced laryngeal and hypopharyngeal cancer: Outcome prediction after one cycle induction chemotherapy by a score based on clinical evaluation, computed tomography-based volumetry. Eur. J. Cancer 2017, 72, 144–155. [Google Scholar] [CrossRef] [PubMed]
- Semrau, S.; Haderlein, M.; Schmidt, D.; Lell, M.; Wolf, W.; Waldfahrer, F.; Uder, M.; Iro, H.; Kuwert, T.; Fietkau, R. Single-cycle induction chemotherapy followed by chemoradiotherapy or surgery in patients with head and neck cancer: What are the best predictors of remission and prognosis? Cancer 2015, 121, 1214–1222. [Google Scholar] [CrossRef] [Green Version]
- Succo, G.; Crosetti, E. Limitations and Opportunities in Open Laryngeal Organ Preservation Surgery: Current Role of OPHLs. Front. Oncol. 2019, 9, 408. [Google Scholar] [CrossRef]
- Wiegand, S. Evidence and evidence gaps of laryngeal cancer surgery. GMS Curr. Top. Otorhinolaryngol. Head Neck Surg. 2016, 15, Doc03. [Google Scholar]
- Gorphe, P. A Contemporary Review of Evidence for Transoral Robotic Surgery in Laryngeal Cancer. Front. Oncol. 2018, 8, 121. [Google Scholar] [CrossRef] [Green Version]
- Succo, G.; Bussi, M.; Presutti, L.; Cirillo, S.; Crosetti, E.; Bertolin, A.; Giordano, L.; Molteni, G.; Petracchini, M.; Sprio, A.E.; et al. Supratracheal laryngectomy: Current indications and contraindications. Acta Otorhinolaryngol. Ital. 2015, 35, 146–156. [Google Scholar] [PubMed]
- Succo, G.; Crosetti, E.; Bertolin, A.; Lucioni, M.; Arrigoni, G.; Panetta, V.; Sprio, A.E.; Berta, G.N.; Rizzotto, G. Benefits and drawbacks of open partial horizontal laryngectomies, Part B: Intermediate and selected advanced stage laryngeal carcinoma. Head Neck 2016, 38, E649–E657. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mercante, G.; Grammatica, A.; Battaglia, P.; Cristalli, G.; Pellini, R.; Spriano, G. Supracricoid partial laryngectomy in the management of t3 laryngeal cancer. Otolaryngol. Head. Neck Surg. 2013, 149, 714–720. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Caudell, J.J.; Torres-Roca, J.F.; Gillies, R.J.; Enderling, H.; Kim, S.; Rishi, A.; Moros, E.G.; Harrison, L.B. The future of personalised radiotherapy for head and neck cancer. Lancet Oncol. 2017, 18, e266–e273. [Google Scholar] [CrossRef]
- Bogowicz, M.; Riesterer, O.; Ikenberg, K.; Stieb, S.; Moch, H.; Studer, G.; Guckenberger, M.; Tanadini-Lang, S. Computed Tomography Radiomics Predicts HPV Status and Local Tumor Control After Definitive Radiochemotherapy in Head and Neck Squamous Cell Carcinoma. Int. J. Radiat. Oncol. Biol. Phys. 2017, 99, 921–928. [Google Scholar] [CrossRef] [PubMed]
- O’Neill, C.B.; O’Neill, J.P.; Atoria, C.L.; Baxi, S.S.; Henman, M.C.; Ganly, I.; Elkin, E.B. Treatment complications and survival in advanced laryngeal cancer: A population-based analysis. Laryngoscope 2014, 124, 2707–2713. [Google Scholar] [CrossRef] [Green Version]
- Ko, H.C.; Harari, P.M.; Chen, S.; Wieland, A.M.; Yu, M.; Baschnagel, A.M.; Kimple, R.J.; Witek, M.E. Survival Outcomes for Patients With T3N0M0 Squamous Cell Carcinoma of the Glottic Larynx. JAMA Otolaryngol. Head Neck Surg. 2017, 143, 1126–1133. [Google Scholar] [CrossRef]
- Bates, J.E.; Amdur, R.J.; Morris, C.M.; Hitchcock, K.E.; Dziegielewski, P.T.; Boyce, B.J.; Silver, N.L.; Shaw, C.; Mendenhall, W.M. Curative-dose Chemoradiotherapy Versus Total Laryngectomy For Stage T3-T4 Squamous Cell Carcinoma of the Larynx: An “Apples-to-Apples” Analysis of the National Cancer Database. Am. J. Clin. Oncol. 2019, 42, 527–533. [Google Scholar] [CrossRef]
- Timmermans, A.J.; de Gooijer, C.J.; Hamming-Vrieze, O.; Hilgers, F.J.M.; van den Brekel, M.W.M. T3-T4 laryngeal cancer in The Netherlands Cancer Institute; 10-year results of the consistent application of an organ-preserving/-sacrificing protocol. Head Neck 2015, 37, 1495–1503. [Google Scholar] [CrossRef]
- Timme, D.W.; Jonnalagadda, S.; Patel, R.; Rao, K.; Robbins, K.T. Treatment Selection for T3/T4a Laryngeal Cancer: Chemoradiation Versus Primary Surgery. Ann. Otol. Rhinol. Laryngol. 2015, 124, 845–851. [Google Scholar] [CrossRef]
- Bussu, F.; Miccichè, F.; Rigante, M.; Dinapoli, N.; Parrilla, C.; Bonomo, P.; Cadoni, G.; Mantini, G.; Galli, J.; Rufini, V.; et al. Oncologic outcomes in advanced laryngeal squamous cell carcinomas treated with different modalities in a single institution: A retrospective analysis of 65 cases. Head Neck 2012, 34, 573–579. [Google Scholar] [CrossRef] [PubMed]
- Hutcheson, K.A.; Barringer, D.A.; Rosenthal, D.I.; May, A.H.; Roberts, D.B.; Lewin, J.S. Swallowing outcomes after radiotherapy for laryngeal carcinoma. Arch. Otolaryngol. Head. Neck Surg. 2008, 134, 178–183. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Grover, S.; Swisher-McClure, S.; Mitra, N.; Li, J.; Cohen, R.B.; Ahn, P.H.; Lukens, J.N.; Chalian, A.A.; Weinstein, G.S.; O’Malley, B.W.; et al. Total Laryngectomy Versus Larynx Preservation for T4a Larynx Cancer: Patterns of Care and Survival Outcomes. Int. J. Radiat. Oncol. Biol. Phys. 2015, 92, 594–601. [Google Scholar] [CrossRef] [PubMed]
- Vengalil, S.; Giuliani, M.E.; Huang, S.H.; McNiven, A.; Song, Y.; Xu, W.; Chan, B.; Hope, A.; Cho, J.; Bayley, A.; et al. Clinical outcomes in patients with T4 laryngeal cancer treated with primary radiotherapy versus primary laryngectomy. Head Neck 2016, 38, E2035–E2040. [Google Scholar] [CrossRef] [PubMed]
- Stokes, W.A.; Jones, B.L.; Bhatia, S.; Oweida, A.J.; Bowles, D.W.; Raben, D.; Goddard, J.A.; McDermott, J.D.; Karam, S.D. A comparison of overall survival for patients with T4 larynx cancer treated with surgical versus organ-preservation approaches: A National Cancer Data Base analysis. Cancer 2017, 123, 600–608. [Google Scholar] [CrossRef] [PubMed]
- Beitler, J.J.; Ridge, J.A.; Vermorken, J.B.; Bradford, C.R.; Strojan, P.; Saba, N.F.; Suárez, C.; Rodrigo, J.P.; Rinaldo, A.; Chen, A.Y.; et al. T4 Laryngeal Cancer With Good Function: Should We Be Reluctant to Treat Without Surgery? Int. J. Radiat. Oncol. Biol. Phys. 2018, 102, 1400–1403. [Google Scholar] [CrossRef] [Green Version]
- Lassig, A.A.D.; Joseph, A.M.; Lindgren, B.R.; Fernandes, P.; Cooper, S.; Schotzko, C.; Khariwala, S.; Reynolds, M.; Yueh, B. The effect of treating institution on outcomes in head and neck cancer. Otolaryngol. Head Neck Surg. 2012, 147, 1083–1092. [Google Scholar] [CrossRef]
- Wuthrick, E.J.; Zhang, Q.; Machtay, M.; Rosenthal, D.I.; Nguyen-Tan, P.F.; Fortin, A.; Silverman, C.L.; Raben, A.; Kim, H.E.; Horwitz, E.M.; et al. Institutional clinical trial accrual volume and survival of patients with head and neck cancer. J. Clin. Oncol. 2015, 33, 156–164. [Google Scholar] [CrossRef]
- David, J.M.; Ho, A.S.; Luu, M.; Yoshida, E.J.; Kim, S.; Mita, A.C.; Scher, K.S.; Shiao, S.L.; Tighiouart, M.; Zumsteg, Z.S. Treatment at high-volume facilities and academic centers is independently associated with improved survival in patients with locally advanced head and neck cancer. Cancer 2017, 123, 3933–3942. [Google Scholar] [CrossRef] [Green Version]
- Bossi, P.; Miceli, R.; Benasso, M.; Corvò, R.; Bacigalupo, A.; Sanguineti, G.; Fallai, C.; Merlano, M.C.; Infante, G.; Dani, C.; et al. Impact of treatment expertise on the outcome of patients with head and neck cancer treated within 6 randomized trials. Head Neck 2018, 40, 2648–2656. [Google Scholar] [CrossRef]
- Lin, C.C.; Fedewa, S.A.; Prickett, K.K.; Higgins, K.A.; Chen, A.Y. Comparative effectiveness of surgical and nonsurgical therapy for advanced laryngeal cancer. Cancer 2016, 122, 2845–2856. [Google Scholar] [CrossRef] [PubMed]
- Haddad, R.; O’Neill, A.; Rabinowits, G.; Tishler, R.; Khuri, F.; Adkins, D.; Clark, J.; Sarlis, N.; Lorch, J.; Beitler, J.J.; et al. Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM): A randomised phase 3 trial. Lancet Oncol. 2013, 14, 257–264. [Google Scholar] [CrossRef]
- Cohen, E.E.W.; Karrison, T.G.; Kocherginsky, M.; Mueller, J.; Egan, R.; Huang, C.H.; Brockstein, B.E.; Agulnik, M.B.; Mittal, B.B.; Yunus, F.; et al. Phase III Randomized Trial of Induction Chemotherapy in Patients With N2 or N3 Locally Advanced Head and Neck Cancer. J. Clin. Oncol. 2014, 32, 1–13. [Google Scholar] [CrossRef] [PubMed]
- Hsin, L.-J.; Fang, T.-J.; Tsang, N.-M.; Chin, S.-C.; Yen, T.-C.; Li, H.-Y.; Liao, C.-T.; Chen, I.-H. Tumor volumetry as a prognostic factor in the management of T4a laryngeal cancer. Laryngoscope 2014, 124, 1134–1140. [Google Scholar] [CrossRef]
- Agrawal, A.; Moon, J.; Davis, R.K.; Sakr, W.A.; Giri, S.P.G.; Valentino, J.; LeBlanc, M.; Truelson, J.M.; Yoo, G.H.; Ensley, J.F.; et al. Transoral carbon dioxide laser supraglottic laryngectomy and irradiation in stage I, II, and III squamous cell carcinoma of the supraglottic larynx: Report of Southwest Oncology Group Phase 2 Trial S9709. Arch. Otolaryngol. Head. Neck Surg. 2007, 133, 1044–1050. [Google Scholar] [CrossRef] [Green Version]
- Nutting, C.M.; Morden, J.P.; Harrington, K.J.; Urbano, T.G.; Bhide, S.A.; Clark, C.; Miles, E.A.; Miah, A.B.; Newbold, K.; Tanay, M.; et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): A phase 3 multicentre randomised controlled trial. Lancet Oncol. 2011, 12, 127–136. [Google Scholar] [CrossRef] [Green Version]
- Lyhne, N.M.; Johansen, J.; Kristensen, C.A.; Andersen, E.; Primdahl, H.; Andersen, L.J.; Bøje, C.R.; Jensen, A.R.; Overgaard, J. Pattern of failure in 5001 patients treated for glottic squamous cell carcinoma with curative intent—A population based study from the DAHANCA group. Radiother. Oncol. 2016, 118, 257–266. [Google Scholar] [CrossRef]
- Bonner, J.A.; Harari, P.M.; Giralt, J.; Cohen, R.B.; Jones, C.U.; Sur, R.K.; Raben, D.; Baselga, J.; Spencer, S.A.; Zhu, J.; et al. Radiotherapy plus cetuximab for locoregionally advanced head and neck cancer: 5-year survival data from a phase 3 randomised trial, and relation between cetuximab-induced rash and survival. Lancet Oncol. 2010, 11, 21–28. [Google Scholar] [CrossRef]
- Blanchard, P.; Baujat, B.; Holostenco, V.; Bourredjem, A.; Baey, C.; Bourhis, J.; Pignon, J.-P. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): A comprehensive analysis by tumour site. Radiother. Oncol. 2011, 100, 33–40. [Google Scholar] [CrossRef]
- Higgins, K.M.; Shah, M.D.; Ogaick, M.J.; Enepekides, D. Treatment of early-stage glottic cancer: Meta-analysis comparison of laser excision versus radiotherapy. J. Otolaryngol. Head Neck Surg. 2009, 38, 603–612. [Google Scholar]
Stage | Local Control | Disease-Specific Survival | Disease-Free Survival | Overall Survival | Voice | Laryngeal Preservation | Comment |
---|---|---|---|---|---|---|---|
% | |||||||
T1a | RT: 93 TOLS: 81 [14] | RT: 96 TOLS: 100 [14] | RT: 78 TOLS: 69 [14,15] | RT: 86–89 TOLS: 86–87 [14] | Significantly better VHI, GRBAS, jitter, shimmer, noise-harmonic rate and maximum phonation time after RT (1) [14,16] | RT: 77–93 TOLS: 69–100 [14] | No significant difference except for (1) |
T1b | RT: 86 TOLS: 95 in 2 years * [17] | RT: 86 TOLS: 89 in 2 years * [17] | RT: 95 TOLS: 94 in 2 years * [17] | Significantly better VHI and less voice deficiency after RT (1) [14] | RT: 86 TOLS: 100 in 2 years * [17] | No significant difference except for (1) | |
T1a-b mixed | RT: 87-94 TOLS: 75–91 (1) [5,14,18] | RT: 96–97 TOLS: 100 [5,14] | RT: 87% TOLS: 75% (1) [5] | RT: 79–89 TOLS: 86–91 [5,14,18] | Significantly better understandability and VHI scores after RT (2) [14,19] No difference (3) [18] Varied (4) [20] | RT:93–94 TOLS: 100 [14,18] | No significant difference except for (1): one study [5] showed better LC and DFS after RT. (2): Better understandability and VHI scores after RT (3): One study [18] showed no difference. (4): One study [20] showed worse GRBAS if cordectomy > type II |
T2 | RT: 76 TOLS: 88 in 3 years * [21] | RT: 71 TOLS: 88 in 3 years * [21] | RT: 94 TOLS: 100 in 3 years * [21] | No significant difference despite selection bias | |||
T1-2 mixed | RT: 86 TOLS: 75 [14] | RT: 94 TOLS: 99 [14] | RT: 72 TOLS: 90 [14] | Significantly better VHI and understandability after RT(1) [14,19] | RT: 76-83 TOLS: 87-93(2) [14,19] | No significant difference except for (1) and (2): One study [14] showing better (93% vs. 83%) laryngeal preservation after TOLS, whereas RT was more often offered for advanced stages. |
Stage | Loco-Regional Control | Overall Survival | Laryngeal Preservation | Comment |
---|---|---|---|---|
T3N0-3 | CRT: 45–61 RT: 35–51 Surg.: 52 Surg. + RT: 54 Surg. + CRT: 50 TLE + (C) RT: 46–53 [97,98,99,100] | CRT: 43–65 in 2 years * [100,101] | Equivalent OS among all compared groups OS: T3N0 > T3N+ (65 vs. 35, sign.) [99] | |
T4N0-3 | CRT: 56.2 TLE + CRT: 86.6 [80] | Ind. CX + CRT: 45 CRT: 33–37 RT: - Surg.: - Surg. + RT: - Surg. + CRT: - TLE + (C) RT: 48.9–58 [75,80,81,82] | CRT: 17–66 in 2 years * [100,101] | Significant better LRC and OS after primary TLE than CRT OS: T4N0 > T4N+ (58 vs. 35, sign.) [99] |
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Elicin, O.; Giger, R. Comparison of Current Surgical and Non-Surgical Treatment Strategies for Early and Locally Advanced Stage Glottic Laryngeal Cancer and Their Outcome. Cancers 2020, 12, 732. https://doi.org/10.3390/cancers12030732
Elicin O, Giger R. Comparison of Current Surgical and Non-Surgical Treatment Strategies for Early and Locally Advanced Stage Glottic Laryngeal Cancer and Their Outcome. Cancers. 2020; 12(3):732. https://doi.org/10.3390/cancers12030732
Chicago/Turabian StyleElicin, Olgun, and Roland Giger. 2020. "Comparison of Current Surgical and Non-Surgical Treatment Strategies for Early and Locally Advanced Stage Glottic Laryngeal Cancer and Their Outcome" Cancers 12, no. 3: 732. https://doi.org/10.3390/cancers12030732