Organ preservation for advanced laryngeal carcinoma.
BACKGROUND
Inclusion of patients with mobile vocal cords on larynx preservation trials may lead to overstatement of larynx preservation (LPR) and survival (OS) rates.


METHODS
This is a retrospective review of patients at our institution who would have been eligible for the Department of Veterans Affairs Laryngeal Cancer Study Group (VA) and Radiation Therapy Oncology Group/Head and Neck Intergroup (RTOG 91-11) clinical trials. No laryngeal conservation procedure could be performed in patients with mobile vocal cords.


RESULTS
One hundred one patients at our institution would have been eligible for the VA trial. The 2-year OS was 76% for total laryngectomy and 90% for radiotherapy patients (p = .28) compared with 68% reported for the VA trial. Seventy-three patients at our institution would have been eligible for the RTOG 91-11 trial. The 5-year OS was 52% for total laryngectomy and 63% for radiotherapy patients (p = .18) compared with 55% reported for the RTOG 91-11 trial. Radiotherapy patients had an LPR of 80% (VA trial) and 86% (RTOG 91-11 trial).


CONCLUSIONS
It is unlikely that inclusion of patients with mobile vocal cords had a significant impact on OS or LPR for the VA and RTOG 91-11 larynx preservation trials.
Foote
Robert L
RL
Department of Radiation Oncology, Mayo Clinic College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. foote.robert@mayo.edu
Foote
R Tyler
RT
Brown
Paul D
PD
Garces
Yolanda I
YI
Okuno
Scott H
SH
Strome
Scott E
SE
D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy; D007830:Larynx / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome