Laryngeal preservation in ENT oncology. Retrospective series of 246 patients managed in the Caen University Hospital and François Baclesse Cancer Care Center between 1998 and 2008 - 14/06/15
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Abstract |
Objectives |
A 10-year retrospective study investigated factors for survival and laryngeal preservation in advanced laryngeal, hypopharyngeal or epilaryngeal neoplasia.
Material and method |
Two hundred and forty-six patients with advanced cancer of the larynx (17.48%), hypopharynx (48.78%) or epilarynx (33.74%) undergoing primary organ-sparing treatment were included from 1998 to 2008. Treatment comprised chemotherapy followed by radiation therapy for 92.68% of patients, isolated radiation therapy for 1.6% and concomitant or sequential radiation-chemotherapy for 5.7%. General health status, history and tumor status were recorded. Factors influencing survival were analyzed by Kaplan-Meier estimator, log-rank test and Cox models.
Results |
Median overall survival of the population was 2.3 years and median laryngeal preservation 0.99 years in male patients and 2 years in female patients. Survival correlated significantly with body mass index (BMI; P=0.0004), WHO performance status (P=0.0064), alcohol consumption (P=0.0004) and cessation (P<0.0001) and also T stage (P=0.0038), initial laryngeal mobility (P=0.0002) and post-chemotherapy assessment (P<0.0001). Survival with functional larynx correlated with baseline BMI at first consultation (P=0.016), baseline WHO grade (P=0.0005), laryngeal mobility (P<0.0001), T staging (P=0.0009), and T and/or N chemotherapy response to a classical organ preservation protocol (P<0.0001).
Conclusion |
Over and above established criteria, the present study highlighted the importance of general health and nutritional status during treatment.
Le texte complet de cet article est disponible en PDF.Keywords : Laryngeal cancer, Laryngeal preservation, BMI, Chemotherapy, Radiation therapy, Laryngeal surgery
Plan
Vol 132 - N° 3
P. 129-134 - juin 2015 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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