Article
Study on indication of postoperative radiotherapy in pT3 laryngeal cancer
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Published: | August 8, 2007 |
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Outline
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In general, postoperative radiotherapy is recommended in patients with (p)T3 laryngeal carcinoma. This recommendation was illuminated within a retrospective analysis of 147 patients (97,3% male) with pT3 laryngeal cancer treated by initial surgery. 36,7% suffered from supraglottic cancer, 73,3% from glottic cancer.
In supraglottic cancer postoperative radiotherapy was performed in 55,6%, in glottic cancer in 34,4%.
In glottic cancer, recurrence free five year survival rates were 79,5% with surgery alone and 71,6% with surgery followed by radiotherapy (p=0,57). In supraglottic carcinoma the survival rates were 87,4% and 65,3% respectively (p=0,08). Cervical metastasis was significantly more present in the subgroups with irradiation. In N0 neck no benefit of postoperative radiotherapy was determined.
Local recurrences were observed in supraglottic cancer in 16,7% without radiation and in 11,5% after radiation (p=0,73). In glottic cancer local recurrences appeared in 13,3% and 6,3% respectively (p=0,72).
This data is not suitable to conclude that postoperative radiation therapy is useless in laryngeal cancer. However, pT3 is no stand alone factor for decision. pN category demonstrated to be an explicit prognostic factor.
The data presented should lead to a subtle discussion about adjuvant radiotherapy in laryngeal cancer.