gms | German Medical Science

Introduction: in the past two decades according to studies published in the early '90s the standard treatment of advanced laryngeal and hypopharyngeal carcinomas has been changed: instead of radical surgery larynx-preserving methods came into view.

Method and patients: to evaluate our results with this new approach we conducted a retrospective study summarizing the treatment data of the patients received non-surgical (n=44) or surgical (n=207) therapy for their advanced, resectable laryngeal or hypopharyngeal cancer in the National Institute of Oncology between 2002 and 2007. Non-surgical treatment consisted of platinum base chemoradiotherapy plus salvage surgery if needed, while as surgical treatment patients underwent laryngectomy with or without neck dissection followed by radiotherapy or chemoradiotherapy.

Results: with non-surgical treatment the one-year laryngoesophageal dysfunction (LED) free survival (the patient is alive with functioning larynx without local relapse, tracheostomy or feeding tube) is 82.9% (SD:0.0592), at 24 months 79.8% (SD:0.0645). Non-surgical treatment proved to be beneficial respecting distant metastases as well (9,09% in non-surgical and 27,08% in surgical group at two years, respectively). Formation of second primary tumor was more frequent in non-surgical group (11.36% vs 8,33%). There was no significant difference in overall survival between treatment groups if stratified according to primary tumor site and stage.

Conclusion: the results of larynx preserving treatments conducted in our Institute are similar to those published in the literature, confirming this method as standard therapy in this group of patients.