Oncological and Functional Outcomes of Conservation Surgery for Carcinoma Glottis
- PDF / 611,386 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 32 Downloads / 182 Views
ORIGINAL ARTICLE
Oncological and Functional Outcomes of Conservation Surgery for Carcinoma Glottis Bipin T. Varghese 1
&
Abid Mirza 2
Received: 5 March 2020 / Accepted: 30 June 2020 # Indian Association of Surgical Oncology 2020
Abstract Conservation laryngectomy has gained considerable acceptance as a means of enhancing overall long-term function preservation in the management of glottic cancers. This study aims to evaluate the oncological and functional outcomes of conservation surgery for carcinoma of the glottis. Fifty consecutive conservation laryngectomies from January 2010 to December 2018 were studied. Glottic cancers of stages I to IVa were carefully selected both in the primary and salvage settings after a consensus from the multidisciplinary tumour board (MDT). Oncological outcomes in terms of overall survival and disease-free survival were measured, and the long-term functional outcomes of voice and swallowing were evaluated using the GRBAS vocal scale and SWAL-QOL questionnaire. The median follow-up period was 63.4 months. The overall 5-year survival probability was 98% (standard error 2.2%), while median disease-free survival was 23 months. The median GRBAS scores in the open and transoral laser microsurgery (TOLMS) group were 1.828 and 1.428, respectively. The median SWAL-QOL scores in majority of quality of life domains were in the mild or no disease impact zone (71–100). Conservative laryngeal surgery plays a crucial role in the treatment of glottic cancers in all stages. It is oncologically safe, and the functional outcomes are favourable. Keywords Transoral laser microsurgery . Open partial laryngectomy . Outcomes
Introduction Laryngeal cancer is the ninth and seventh most common cause of cancer in males in Asia and India, respectively. According to the 2018 GLOBOCAN database, an estimated 177,422 new cases were diagnosed with laryngeal cancer worldwide, and 94,771 succumbed to their disease [1]. In India, the incidence of laryngeal cancer has been reported to be 1.26–8.18 per 100,000 population [2]. Traditional treatment modalities for early carcinoma larynx included primary radical radiotherapy and salvage total laryngectomy (RRSS) [3, 4], while surgical conservative approaches, i.e. transoral laser surgery and partial laryngectomy, were sparsely practised [5–7]. Over the 3
* Bipin T. Varghese [email protected] 1
Head and Neck Surgical Oncology Unit, Additional Professor Head and Neck Surgery, Department of Surgical Services, Regional Cancer Centre, Trivandrum, Kerala 695011, India
2
Head and Neck Surgical Oncology Unit, MCh Surgical Oncology PG Trainee, Regional Cancer Centre, Trivandrum, Kerala 695011, India
decades, significant advances have taken place in non-surgical approaches with the advent of chemotherapy-enhanced radiotherapy concept [8], and the overall treatment paradigm has essentially shifted to non-surgical approaches. Technical improvements in delivery of radiation as well as development and popularization of conservative surgical techniques have further enhanced the
Data Loading...
