title: Oncologic and functional outcomes in advanced laryngeal and hypopharyngeal cancer treated with concurrent chemoradiation versus primary surgery followed by adjuvant treatment.
abstract: OBJECTIVE
  To compare oncologic outcomes in advanced laryngeal and hypopharyngeal cancer (LHC) patients who received either concurrent chemoradiation (CRT) or primary surgery followed by adjuvant treatment and to examine functional outcomes in the patients treated with CRT.
  
  
  METHODS
  The clinicopathological data of 136 patients, diagnosed as stage III or IV LHC, were retrospectively reviewed. The eligible patients were classified into two groups based on their primary treatment, CRT group and group of surgery followed by the adjuvant treatment. Oncologic outcomes were evaluated and compared at five years. Functional outcomes were recorded as tracheostomy and/or feeding tube dependency.
  
  
  RESULTS
  Five-year overall survival rates were 66.9% for the primary surgery group and 34.8% for the CRT group (p = 0.004). Five-year disease-specific survival rates for the same two groups were 66.9% and 39.9%, respectively (p = 0.03). The three-year laryngectomy-free survival rate in the CRT group was 71.9%. At three months post-CRT 62.3% of patients depended on tracheostomy and/or a feeding tube.
  
  
  CONCLUSIONS
  The primary surgery followed by adjunctive treatment among the advanced LHC cases had significantly better oncologic outcomes. Nevertheless, CRT group had a high survival rate with a preserved larynx, but with relatively inferior functional outcomes.
authors.affiliation: Department of Otolarynglogy Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. kittient@hotmail.com
authors.forename: Kitti
authors.initials: K
authors.lastname: Jantharapattana
mesh_terms: D000368:Aged; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D014139:Tracheostomy; D016896:Treatment Outcome