[Conservative surgery of the larynx as an alternative to total laryngectomy after neoadjuvant chemotherapy. Initial results].
A retrospective study of 149 squamous cell carcinomas of the larynx and epilarynx in whom a total laryngectomy was initially planned is reported. All the patients were treated by neoadjuvant chemotherapy. After completion of chemotherapy, the initially planned therapeutic protocol was modified in 56 patients (37.6%) in order to preserve the laryngeal physiologic functions. A total laryngectomy was performed in 23 patients (41%), radiation therapy was administered to 14 (25%) patients chemotherapy was prolonged in 15 patients (26.8%) and four deaths were related to chemotherapy toxicity (7.2%). Actuarial survival of patients treated by partial laryngectomy was statistically higher than survivals of patients treated either by radiation therapy or prolonged chemotherapy. After completion of neoadjuvant therapy patients who refused a total laryngectomy had the worst survival of the series. These results suggest that surgery of the residual tumor (partial laryngectomy) after neoadjuvant chemotherapy could be indicated for selected laryngeal carcinoma in whom a total laryngectomy was initially planned.
Brasnu
D
D
Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-faciale, Université René Descartes, UFR Necker Enfants Malades, Hôpital Laënnec, Paris.
Laccourreye
O
O
Chabardes
E
E
Bassot
V
V
Ménard
M
M
Laccourreye
H
H
D000206:Actuarial Analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate
Chirurgie conservatrice du larynx comme alternative a la laryngectomie totale après chimiothérapie néo-adjuvante. Résultats préliminaries.