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 journalArticlepeer-review

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 languageEnglish (US)
Pages (from-to)1739-1751
Number of pages13
JournalHead and Neck
Volume38
Issue number12
DOIs
StatePublished - Dec 1 2016
Externally publishedYes

Keywords

  • T3
  • outcomes
  • radiotherapy
  • survival
  • total laryngectomy

ASJC Scopus subject areas

  • Otorhinolaryngology

Fingerprint

Dive into the research topics of 'Long-term outcomes after multidisciplinary management of T3 laryngeal squamous cell carcinomas: Improved functional outcomes and survival with modern therapeutic approaches'. Together they form a unique fingerprint.

Cite this