Titre
Horizontal partial laryngectomy for supraglottic squamous cell carcinoma
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Bron, L. P.
Auteure/Auteur
Soldati, D.
Auteure/Auteur
Monod, M. L.
Auteure/Auteur
Megevand, C.
Auteure/Auteur
Brossard, E.
Auteure/Auteur
Monnier, P.
Auteure/Auteur
Pasche, P.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
0937-4477
Statut éditorial
Publié
Date de publication
2005-04
Volume
262
Numéro
4
Première page
302
Dernière page/numéro d’article
6
Notes
Journal Article --- Old month value: Apr
Résumé
Between 1981-1999, 75 patients treated for supraglottic SCC with horizontal supraglottic laryngectomy (HSL) at the Otolaryngology Head and Neck Surgery Department of Lausanne University Hospital were retrospectively studied. There were 16 patients with T1, 46 with T2 and 13 with T3 tumors. Among these, 16 patients (21%) had clinical neck disease corresponding to stage I, II, III and IV in 12, 39, 18 and 6 patients, respectively. All patients had HSL. Most patients had either elective or therapeutic bilateral level II-IV selective neck dissection. Six patients (8%) with advanced neck disease had ipsilateral radical and controlateral elective II-IV selective neck dissections. Adjuvant radiotherapy was given to 25 patients (30%) for either positive surgical margins (n=8), pathological nodal status (n=14) or both (n=3). Median follow-up was 48 months (range, 24-199). Five-year disease-specific survival and locoregional and local control were 92, 90 and 92.5%, respectively. Among five patients who were diagnosed with local recurrence, one had a total laryngectomy (1.4%); the others were treated by endoscopic laser surgery. Two patients had both a local and regional recurrence. They were salvaged with combined surgery and radiotherapy, but eventually died of their disease. Cartilage infiltration seems to influence both local control (P=0.03) and disease-specific survival (P=0.06). There was a trend for worse survival with pathological node involvement (P=0.15) and extralaryngeal extension of the cancer (P=0.1). All patients except one recovered a close to normal function after the treatment. Aspiration was present in 16 patients (26%) in the early postoperative period. A median of 16 days (7-9) was necessary to recover a close to normal diet. Decannulation took a median of 17 days (8-93). Seven patients kept a tracheotomy tube for up to 3 months because of persistent aspiration. There was no permanent tracheostomy or total laryngectomy for functional purposes. Horizontal supraglottic laryngectomy remains an adequate therapeutic alternative for supraglottic squamous cell carcinoma, offering an excellent oncological outcome. The postoperative functional morbidity is substantial, indicating the need for careful patient selection, but good laryngeal function recovery is the rule. The surgical alternative is endoscopic laser surgery, which may offer comparable oncological results with less functional morbidity. Nevertheless, these two different techniques need to be compared prospectively.
Sujets
PID Serval
serval:BIB_A2B0993C99AF
PMID
Open Access
Oui
Date de création
2008-01-25T15:47:15.944Z
Date de création dans IRIS
2025-05-21T01:17:19Z
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Nom
REF.pdf
Version du manuscrit
published
Taille
123.14 KB
Format
Adobe PDF
PID Serval
serval:BIB_A2B0993C99AF.P001
URN
urn:nbn:ch:serval-BIB_A2B0993C99AF6
Somme de contrôle
(MD5):4ca8b9fa3b767ed662f96037c603740e