title: Otorhinolaryngologists' personal treatment preferences (total laryngectomy or laryngeal preservation) when faced with advanced stage laryngeal cancer.
abstract: OBJECTIVE
  To analyse the treatment options that otorhinolaryngologists would consider if faced with advanced stage laryngeal cancer amenable to total laryngectomy or an organ preservation protocol.
  
  
  METHODS
  Prospective study conducted in a French Teaching Hospital based on questionnaires filled in by 163 otorhinolaryngologists in 2012, studying the percentage chance of cure that they would be prepared to trade-off to preserve their larynx, defining the additional information that they would like to receive and identifying any statistical associations between these parameters and various medical and socioeconomic variables.
  
  
  RESULTS
  A total of 42.3% of otorhinolaryngologists would not consider the slightest trade-off to preserve their larynx and preferred to undergo total laryngectomy. In the group of otorhinolaryngologists who would consider a larynx preservation protocol (57.6%), the percentage chance of cure that they would be willing to trade-off to preserve their larynx ranged between 5 to 100% (median: 15%) and 4.2% of them were willing to trade-off all chances of cure (100%) to avoid total laryngectomy. The percentage of otorhinolaryngologists who would not consider trading off the slightest chance of survival to preserve their larynx increased from 29.3 to 49.5% (P=0.01) when they participated in multidisciplinary consultation meetings. In the group of otorhinolaryngologists who would consider a larynx preservation protocol, the median percentage survival trade-off that they would consider in order to preserve their larynx (i) decreased from 20 to 10% (P=0.004) when they participated in multidisciplinary consultation meetings and (ii) increased regularly with their number of years of practice (P=0.03) and their age (P=0.025). Finally, 25.1% of otorhinolaryngologists wanted to receive additional information, although none of the variables analysed affected this desire for more information.
  
  
  CONCLUSIONS
  Treatment options considered by otorhinolaryngologists faced with advanced stage laryngeal cancer were almost equally divided between total laryngectomy and larynx preservation. Number of years of practice and regular participation in head and neck cancer multidisciplinary consultation meetings were variables that significantly influenced this choice.
authors.affiliation: Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France. Electronic address: ollivier.laccourreye@egp.aphp.fr.
authors.forename: O
authors.initials: O
authors.lastname: Laccourreye
authors.affiliation: Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Malinvaud
authors.affiliation: Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Ménard
authors.affiliation: Service de psychiatrie, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Consoli
authors.affiliation: Service d'oncologie-radiothérapie, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Giraud
authors.affiliation: Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, université Paris Descartes Sorbonne Paris Cité, hôpital européen Georges-Pompidou, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Bonfils
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005602:France; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011795:Surveys and Questionnaires
keywords: Cancer; Laryngeal preservation; Medical information; Total laryngectomy; Trade-off