title: Comparison of the therapeutic effects of total laryngectomy and a larynx-preservation approach in patients with T4a laryngeal cancer and thyroid cartilage invasion: A multicenter retrospective review.
abstract: In T4a laryngeal cancer with thyroid cartilage invasion, no optimal frontline treatment has yet been defined in controlled trials.
  
  
  
  We reviewed data from 89 patients with T4a laryngeal cancer featuring thyroid cartilage invasion who were treated initially with either total laryngectomy (n = 53) or a larynx-preservation strategy (n = 36).
  
  
  
  The median progression-free survival (PFS) of the total laryngectomy group had not been attained at the time of analysis and was thus significantly longer than that of the larynx-preservation group (8.7 months). The median overall survival (OS) of patients who underwent total laryngectomy was 87.2 months, significantly longer than that of the larynx-preservation group (31.3 months). The survival benefit of primary surgery compared to a larynx-preservation strategy was more striking in patients of lower N classifications.
  
  
  
  Total laryngectomy may be a better therapeutic option to treat T4a laryngeal cancer featuring thyroid cartilage invasion, especially in patients exhibiting limited nodal involvement (N0/N1). © 2016 Wiley Periodicals, Inc. Head Neck, 2016 © 2016 Wiley Periodicals, Inc. Head Neck 38:1271-1277, 2016.
authors.affiliation: Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
authors.forename: Yoon Seok
authors.initials: YS
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Republic of Korea.
authors.forename: Sang Gon
authors.initials: SG
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Republic of Korea.
authors.forename: Eun-Kee
authors.initials: EK
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Chonnam National University Medical School, Hwasoon, Republic of Korea.
authors.forename: Sang-Hee
authors.initials: SH
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Republic of Korea.
authors.forename: Moo-Rim
authors.initials: MR
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Keimyung University College of Medicine, Daegu, Republic of Korea.
authors.forename: Keon Uk
authors.initials: KU
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Republic of Korea.
authors.forename: Ki-Hyeong
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
authors.forename: Ik-Chan
authors.initials: IC
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
authors.forename: Hyo Jin
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
authors.forename: Deog-Yeon
authors.initials: DY
authors.lastname: Jo
authors.affiliation: Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
authors.forename: Samyong
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
authors.forename: Hwan-Jung
authors.initials: HJ
authors.lastname: Yun
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods* / Q000401:mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013957:Thyroid Cartilage / Q000473:pathology*; D016896:Treatment Outcome
keywords: cartilage invasion; laryngeal cancer; larynx preservation; prognosis; total laryngectomy