Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: Improved functional outcomes and survival with modern therapeutic approaches

Clifton D. Fuller; Abdallah S.R. Mohamed; Adam S. Garden; G. Brandon Gunn; Collin F. Mulcahy; Mark Zafereo; Jack Phan; Stephen Y. Lai; Jan S. Lewin; Katherine A. Hutcheson; Steven J. Frank; Beth M. Beadle; William H. Morrison; Adel K. El-Naggar; Esengul Kocak–Uzel; Lawrence E. Ginsberg; Merril S. Kies; Randal S. Weber; David I. Rosenthal

doi:10.1002/hed.24532

Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: Improved functional outcomes and survival with modern therapeutic approaches

Clifton D. Fuller, Abdallah S.R. Mohamed, Adam S. Garden, G. Brandon Gunn, Collin F. Mulcahy, Mark Zafereo, Jack Phan, Stephen Y. Lai, Jan S. Lewin, Katherine A. Hutcheson, Steven J. Frank, Beth M. Beadle, William H. Morrison, Adel K. El-Naggar, Esengul Kocak–Uzel, Lawrence E. Ginsberg, Merril S. Kies, Randal S. Weber, David I. Rosenthal

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Background: The purpose of this study was to evaluate the long-term outcomes after initial definitive or adjuvant radiotherapy (RT) for T3 laryngeal cancers. Methods: We reviewed 412 patients treated for T3 laryngeal squamous cell cancer from 1985 to 2011. Results: The 10-year overall survival (OS) was 35%; disease-specific-survival (DSS) was 61%; locoregional control was 76%; and freedom from distant metastasis was 83%. Chemotherapy, age, performance status <2, node-negative status, and glottic subsite were associated with improved survival (all p <.03). Larynx preservation with induction and/or concurrent chemoradiotherapy (LP-CRT) had better laryngectomy-free survival than RT alone (LP-RT; hazard ratio [HR] = 0.62; 95% confidence interval [CI] = 0.47–0.81; p =.0005); 10-year laryngectomy-free survival rates of the LP-CRT cohort (37%) were higher than those of the LP-RT cohort (18%). The 5-year DSS and OS rates of the LP-CRT cohort (79% and 67%) were better after total laryngectomy with postoperative RT (TL-PORT; 61% and 50%) and LP-RT (64% and 46%; p <.006 for all). Conclusion: In patients with T3 laryngeal cancers, LP-CRT provides better functional, oncologic, and survival outcomes than historical TL-PORT or LP-RT does.

Original language	English (US)
Pages (from-to)	1739-1751
Number of pages	13
Journal	Head and Neck
Volume	38
Issue number	12
DOIs	https://doi.org/10.1002/hed.24532
State	Published - Dec 1 2016

Keywords

T3
outcomes
radiotherapy
survival
total laryngectomy

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.24532

Cite this

Fuller, C. D., Mohamed, A. S. R., Garden, A. S., Gunn, G. B., Mulcahy, C. F., Zafereo, M., Phan, J., Lai, S. Y., Lewin, J. S., Hutcheson, K. A., Frank, S. J., Beadle, B. M., Morrison, W. H., El-Naggar, A. K., Kocak–Uzel, E., Ginsberg, L. E., Kies, M. S., Weber, R. S., & Rosenthal, D. I. (2016). Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: Improved functional outcomes and survival with modern therapeutic approaches. Head and Neck, 38(12), 1739-1751. https://doi.org/10.1002/hed.24532

Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: Improved functional outcomes and survival with modern therapeutic approaches. / Fuller, Clifton D.; Mohamed, Abdallah S.R.; Garden, Adam S. et al.
In: Head and Neck, Vol. 38, No. 12, 01.12.2016, p. 1739-1751.

Research output: Contribution to journal › Article › peer-review

Fuller, CD , Mohamed, ASR , Garden, AS , Gunn, GB, Mulcahy, CF, Zafereo, M , Phan, J , Lai, SY, Lewin, JS, Hutcheson, KA , Frank, SJ, Beadle, BM, Morrison, WH , El-Naggar, AK, Kocak–Uzel, E, Ginsberg, LE, Kies, MS, Weber, RS & Rosenthal, DI 2016, 'Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: Improved functional outcomes and survival with modern therapeutic approaches', Head and Neck, vol. 38, no. 12, pp. 1739-1751. https://doi.org/10.1002/hed.24532

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title = "Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: Improved functional outcomes and survival with modern therapeutic approaches",

abstract = "Background: The purpose of this study was to evaluate the long-term outcomes after initial definitive or adjuvant radiotherapy (RT) for T3 laryngeal cancers. Methods: We reviewed 412 patients treated for T3 laryngeal squamous cell cancer from 1985 to 2011. Results: The 10-year overall survival (OS) was 35%; disease-specific-survival (DSS) was 61%; locoregional control was 76%; and freedom from distant metastasis was 83%. Chemotherapy, age, performance status <2, node-negative status, and glottic subsite were associated with improved survival (all p <.03). Larynx preservation with induction and/or concurrent chemoradiotherapy (LP-CRT) had better laryngectomy-free survival than RT alone (LP-RT; hazard ratio [HR] = 0.62; 95% confidence interval [CI] = 0.47–0.81; p =.0005); 10-year laryngectomy-free survival rates of the LP-CRT cohort (37%) were higher than those of the LP-RT cohort (18%). The 5-year DSS and OS rates of the LP-CRT cohort (79% and 67%) were better after total laryngectomy with postoperative RT (TL-PORT; 61% and 50%) and LP-RT (64% and 46%; p <.006 for all). Conclusion: In patients with T3 laryngeal cancers, LP-CRT provides better functional, oncologic, and survival outcomes than historical TL-PORT or LP-RT does.",

keywords = "T3, outcomes, radiotherapy, survival, total laryngectomy",

author = "Fuller, {Clifton D.} and Mohamed, {Abdallah S.R.} and Garden, {Adam S.} and Gunn, {G. Brandon} and Mulcahy, {Collin F.} and Mark Zafereo and Jack Phan and Lai, {Stephen Y.} and Lewin, {Jan S.} and Hutcheson, {Katherine A.} and Frank, {Steven J.} and Beadle, {Beth M.} and Morrison, {William H.} and El-Naggar, {Adel K.} and Esengul Kocak–Uzel and Ginsberg, {Lawrence E.} and Kies, {Merril S.} and Weber, {Randal S.} and Rosenthal, {David I.}",

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T1 - Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas

T2 - Improved functional outcomes and survival with modern therapeutic approaches

AU - Fuller, Clifton D.

AU - Mohamed, Abdallah S.R.

AU - Garden, Adam S.

AU - Gunn, G. Brandon

AU - Mulcahy, Collin F.

AU - Zafereo, Mark

AU - Phan, Jack

AU - Lai, Stephen Y.

AU - Lewin, Jan S.

AU - Hutcheson, Katherine A.

AU - Frank, Steven J.

AU - Beadle, Beth M.

AU - Morrison, William H.

AU - El-Naggar, Adel K.

AU - Kocak–Uzel, Esengul

AU - Ginsberg, Lawrence E.

AU - Kies, Merril S.

AU - Weber, Randal S.

AU - Rosenthal, David I.

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Background: The purpose of this study was to evaluate the long-term outcomes after initial definitive or adjuvant radiotherapy (RT) for T3 laryngeal cancers. Methods: We reviewed 412 patients treated for T3 laryngeal squamous cell cancer from 1985 to 2011. Results: The 10-year overall survival (OS) was 35%; disease-specific-survival (DSS) was 61%; locoregional control was 76%; and freedom from distant metastasis was 83%. Chemotherapy, age, performance status <2, node-negative status, and glottic subsite were associated with improved survival (all p <.03). Larynx preservation with induction and/or concurrent chemoradiotherapy (LP-CRT) had better laryngectomy-free survival than RT alone (LP-RT; hazard ratio [HR] = 0.62; 95% confidence interval [CI] = 0.47–0.81; p =.0005); 10-year laryngectomy-free survival rates of the LP-CRT cohort (37%) were higher than those of the LP-RT cohort (18%). The 5-year DSS and OS rates of the LP-CRT cohort (79% and 67%) were better after total laryngectomy with postoperative RT (TL-PORT; 61% and 50%) and LP-RT (64% and 46%; p <.006 for all). Conclusion: In patients with T3 laryngeal cancers, LP-CRT provides better functional, oncologic, and survival outcomes than historical TL-PORT or LP-RT does.

AB - Background: The purpose of this study was to evaluate the long-term outcomes after initial definitive or adjuvant radiotherapy (RT) for T3 laryngeal cancers. Methods: We reviewed 412 patients treated for T3 laryngeal squamous cell cancer from 1985 to 2011. Results: The 10-year overall survival (OS) was 35%; disease-specific-survival (DSS) was 61%; locoregional control was 76%; and freedom from distant metastasis was 83%. Chemotherapy, age, performance status <2, node-negative status, and glottic subsite were associated with improved survival (all p <.03). Larynx preservation with induction and/or concurrent chemoradiotherapy (LP-CRT) had better laryngectomy-free survival than RT alone (LP-RT; hazard ratio [HR] = 0.62; 95% confidence interval [CI] = 0.47–0.81; p =.0005); 10-year laryngectomy-free survival rates of the LP-CRT cohort (37%) were higher than those of the LP-RT cohort (18%). The 5-year DSS and OS rates of the LP-CRT cohort (79% and 67%) were better after total laryngectomy with postoperative RT (TL-PORT; 61% and 50%) and LP-RT (64% and 46%; p <.006 for all). Conclusion: In patients with T3 laryngeal cancers, LP-CRT provides better functional, oncologic, and survival outcomes than historical TL-PORT or LP-RT does.

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Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: Improved functional outcomes and survival with modern therapeutic approaches

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