title: Primary total laryngectomy and pharyngolaryngectomy in T4 pharyngolaryngeal cancers: Oncologic and functional results and prognostic factors.
abstract: OBJECTIVE
  The aims of this study were to assess oncologic and functional outcome in primary total laryngectomy or pharyngolaryngectomy (TL/TL/TPL) for laryngeal or hypopharyngeal cancer with extra-laryngeal extension (T4) and to determine the predictive factors of these results.
  
  
  METHODS
  A retrospective analysis was performed on the computerized medical records of all patients undergoing primary TL/TPL for T4 larynx or hypopharynx squamous cell carcinoma between 2000 and 2014 at our institution. Predictive factors of oncologic and functional outcome were investigated on univariate and multivariate analysis.
  
  
  RESULTS
  Sixty-three patients (58 men, 5 women; mean age, 68.8±9.7 years) were included. Overall and disease-specific survivals were 69% and 80% at 3 years, and 56% and 69% at 5 years, respectively. On multivariate analysis, gender (female, P<0.001), ASA score (ASA≥3; P=0.006) and vascular embolism (P=0.006) had significant pejorative impact on overall survival. Six months after end of treatment, 90% of patients had recovered independent oral feeding and 83% of those with tracheoesophageal voice prostheses had recovered an intelligible voice.
  
  
  CONCLUSIONS
  Primary TL/TPL remains the gold standard treatment for T4 larynx or hypopharynx cancer. It provides satisfactory oncologic and functional outcomes.
authors.affiliation: Institut universitaire de la face et du cou, 31, avenue de Valombrose, 06103 Nice, France.
authors.forename: M
authors.initials: M
authors.lastname: Roux
authors.affiliation: Institut universitaire de la face et du cou, 31, avenue de Valombrose, 06103 Nice, France.
authors.forename: O
authors.initials: O
authors.lastname: Dassonville
authors.affiliation: Département de biostatistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France.
authors.forename: M
authors.initials: M
authors.lastname: Ettaiche
authors.affiliation: Département de biostatistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France.
authors.forename: E
authors.initials: E
authors.lastname: Chamorey
authors.affiliation: Institut universitaire de la face et du cou, 31, avenue de Valombrose, 06103 Nice, France.
authors.forename: G
authors.initials: G
authors.lastname: Poissonnet
authors.affiliation: Institut universitaire de la face et du cou, 31, avenue de Valombrose, 06103 Nice, France. Electronic address: alexandre.bozec@nice.unicancer.fr.
authors.forename: A
authors.initials: A
authors.lastname: Bozec
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010611:Pharyngectomy; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Cancer; Hypopharynx; Larynx; Prognosis; Total laryngectomy