title: Does airway intervention before primary nonsurgical therapy for T3/T4 laryngeal squamous cell carcinoma impact on oncological or functional outcomes?
abstract: OBJECTIVE
  Even today, some patients with laryngeal cancer present with airway obstruction necessitating an intervention in the form of either a tracheostomy or transoral laser debulking (TOL). Controversy exists as to whether such an intervention is a risk factor for poor oncological or functional outcome in patients who then undergo primary (chemo)radiotherapy.
  
  
  METHODS
  Retrospective chart review of all patients undergoing primary curative nonsurgical treatment for T3/T4 laryngeal squamous cell cancer at the University Hospital Zurich between 1981 and 2011.
  
  
  RESULTS
  A total of 29/114 patients had an airway intervention before initiation of (chemo)radiotherapy (21/29 tracheostomies, 8/29 TOL). Kaplan-Meier analysis showed no statistical difference in oncological outcomes between the groups with and without intervention (5 year overall survival: 52% vs 70%, disease specific survival: 73% vs 79%, recurrence free survival: 53% vs 63%). In functional terms, we report an overall functional larynx rate of 60%.
  
  
  CONCLUSIONS
  Airway intervention was not found to be a risk factor for poor oncological or functional outcome in this patient group.
authors.affiliation: Dept. of Otorhinolaryngology, Head & Neck surgery, University Hospital Zürich, Switzerland.
authors.forename: René
authors.initials: R
authors.lastname: Schariatzadeh
authors.affiliation: Dept. of Otorhinolaryngology, Head & Neck surgery, University Hospital Zürich, Switzerland.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Pezier
authors.affiliation: Dept. Radiation Oncology, University Hospital Zürich, Switzerland.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Studer
authors.affiliation: Privatklinik Bethanien, Zürich, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Schmid
authors.affiliation: Dept. of Otorhinolaryngology, Head & Neck surgery, University Hospital Zürich, Switzerland.
authors.forename: Gerhard F
authors.initials: GF
authors.lastname: Huber
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000628:therapy*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D013557:Switzerland; D014139:Tracheostomy; D016896:Treatment Outcome