title: Laryngeal preservation in ENT oncology. Retrospective series of 246 patients managed in the Caen University Hospital and François Baclesse Cancer Care Center between 1998 and 2008.
abstract: OBJECTIVE
  A 10-year retrospective study investigated factors for survival and laryngeal preservation in advanced laryngeal, hypopharyngeal or epilaryngeal neoplasia.
  
  
  METHODS
  Two hundred and forty-six patients with advanced cancer of the larynx (17.48%), hypopharynx (48.78%) or epilarynx (33.74%) undergoing primary organ-sparing treatment were included from 1998 to 2008. Treatment comprised chemotherapy followed by radiation therapy for 92.68% of patients, isolated radiation therapy for 1.6% and concomitant or sequential radiation-chemotherapy for 5.7%. General health status, history and tumor status were recorded. Factors influencing survival were analyzed by Kaplan-Meier estimator, log-rank test and Cox models.
  
  
  RESULTS
  Median overall survival of the population was 2.3 years and median laryngeal preservation 0.99 years in male patients and 2 years in female patients. Survival correlated significantly with body mass index (BMI; P=0.0004), WHO performance status (P=0.0064), alcohol consumption (P=0.0004) and cessation (P<0.0001) and also T stage (P=0.0038), initial laryngeal mobility (P=0.0002) and post-chemotherapy assessment (P<0.0001). Survival with functional larynx correlated with baseline BMI at first consultation (P=0.016), baseline WHO grade (P=0.0005), laryngeal mobility (P<0.0001), T staging (P=0.0009), and T and/or N chemotherapy response to a classical organ preservation protocol (P<0.0001).
  
  
  CONCLUSIONS
  Over and above established criteria, the present study highlighted the importance of general health and nutritional status during treatment.
authors.affiliation: Pôle tête et cou, Centre François Baclesse - CHU, 14000 Caen, France; Inserm U1086, Cancers et Préventions, 14000 Caen, France. Electronic address: cuny-f@chu-caen.fr.
authors.forename: F
authors.initials: F
authors.lastname: Cuny
authors.affiliation: Pôle tête et cou, Centre François Baclesse - CHU, 14000 Caen, France.
authors.forename: A
authors.initials: A
authors.lastname: Meunier
authors.affiliation: Inserm U1086, Cancers et Préventions, 14000 Caen, France; GRECAN EA-1772, université Caen - Basse-Normandie, 14000 Caen, France.
authors.forename: N
authors.initials: N
authors.lastname: Heutte
authors.affiliation: Pôle tête et cou, Centre François Baclesse - CHU, 14000 Caen, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Rame
authors.affiliation: Pôle tête et cou, Centre François Baclesse - CHU, 14000 Caen, France.
authors.forename: D
authors.initials: D
authors.lastname: De Raucourt
authors.affiliation: Pôle tête et cou, Centre François Baclesse - CHU, 14000 Caen, France; Inserm U1086, Cancers et Préventions, 14000 Caen, France.
authors.forename: E
authors.initials: E
authors.lastname: Babin
authors.affiliation: Pôle tête et cou, Centre François Baclesse - CHU, 14000 Caen, France; Inserm U1086, Cancers et Préventions, 14000 Caen, France.
authors.forename: D
authors.initials: D
authors.lastname: Blanchard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D005602:France; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000379:methods; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome
keywords: BMI; Chemotherapy; Laryngeal cancer; Laryngeal preservation; Laryngeal surgery; Radiation therapy