title: Tumor Debulking in the Management of Laryngeal Cancer Airway Obstruction.
abstract: Patients presenting with advanced aerodigestive malignancy and respiratory compromise often undergo tracheotomy as initial airway management. Tumor debulking is a potential alternative. We present a case series with chart review to communicate our institutional experience with this technique. T3/4 glottic and supraglottic cancers treated between 2004 and 2014 underwent review, and 14 patients were identified for this study. Of these, 5 (35.7%) required subsequent tracheotomy, and 9 (64.3%) did not. Patients requiring subsequent tracheotomy had a delay in initiating definitive treatment when compared with those who did not (83.3 vs 31.3 days, P = .0025). No patient required a tracheotomy after initiation of definitive treatment. Our experience suggests that tumor debulking may be a viable option in select patients but that a delay in initiating treatment is associated with patients requiring tracheotomy subsequent to debulking. Further research is needed to better delineate patient scenarios in which tumor debulking alone is sufficient.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Eugenie
authors.initials: E
authors.lastname: Du
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.|Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Richard V
authors.initials: RV
authors.lastname: Smith
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.|Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Ow
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Tassler
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA bschiff@montefiore.org.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Schiff
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058109:Airway Management / Q000379:methods*; D000402:Airway Obstruction / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D000077195:Squamous Cell Carcinoma of Head and Neck; D014140:Tracheotomy; D016896:Treatment Outcome
keywords: airway management; debulking; head and neck; squamous cell cancer