Role of imaging in the follow-up of T2-T3 glottic cancer treated by transoral laser microsurgery
An unblinded retrospective analysis of prospectively collected data was carried out on 138 patients affected by glottic pT2 and selected pT3 squamous cell carcinomas (SCC) treated by transoral laser microsurgery (TLM). The entire cohort was divided into two groups: Group A included 78 "high-risk" patients (pT2 with impaired vocal cord mobility, pT3 for anterior paraglottic and/or pre-epiglottic space invasion, presence of angioembolization, perineural spread, and positive lymph nodes in the neck) who underwent postoperative surveillance by endoscopy and imaging (CT or MR), while Group B included 60 "low-risk" patients (pT2 with absence of the above-mentioned features) who underwent endoscopic follow-up alone. Aim of the present study was to assess the diagnostic gain in performing combined endoscopic and radiologic surveillance in the "high-risk" group compared to endoscopy alone in the "low-risk" one. There was no significant difference in terms of overall and disease-specific survivals between the two follow-up policies in spite of their different risk profiles. The same was true for organ preservation rate, which was 81% in the "high-risk" and 89% in the "low-risk" group. In contrast, the cumulative probability of disease-free survival was 54% for Group A and 65% for Group B (p = 0.0023). Therefore, our combined endoscopy and imaging surveillance protocol allowed increasing the submucosal recurrence detection rate in "high-risk" pT2-pT3 glottic SCC to 43%. An earlier detection of submucosal recurrences made salvage surgery by TLM feasible in at least half of cases, thus closing the gap between oncologic outcomes obtained in "high-"- vs. "low-risk" patients and leading to organ preservation rates that are favorably comparable to those obtained with open-neck partial laryngectomies and non-surgical organ preservation protocols.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2017 |
|---|---|
| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:274 |
|---|---|
| Enthalten in: |
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery - 274(2017), 10 vom: 18. Okt., Seite 3679-3686 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Marchi, Filippo [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Endoscopy |
|---|
| Anmerkungen: |
Date Completed 29.05.2018 Date Revised 17.03.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1007/s00405-017-4642-4 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM273094505 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM273094505 | ||
| 003 | DE-627 | ||
| 005 | 20231225000351.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2017 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1007/s00405-017-4642-4 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0910.xml |
| 035 | |a (DE-627)NLM273094505 | ||
| 035 | |a (NLM)28631160 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Marchi, Filippo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Role of imaging in the follow-up of T2-T3 glottic cancer treated by transoral laser microsurgery |
| 264 | 1 | |c 2017 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.05.2018 | ||
| 500 | |a Date Revised 17.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a An unblinded retrospective analysis of prospectively collected data was carried out on 138 patients affected by glottic pT2 and selected pT3 squamous cell carcinomas (SCC) treated by transoral laser microsurgery (TLM). The entire cohort was divided into two groups: Group A included 78 "high-risk" patients (pT2 with impaired vocal cord mobility, pT3 for anterior paraglottic and/or pre-epiglottic space invasion, presence of angioembolization, perineural spread, and positive lymph nodes in the neck) who underwent postoperative surveillance by endoscopy and imaging (CT or MR), while Group B included 60 "low-risk" patients (pT2 with absence of the above-mentioned features) who underwent endoscopic follow-up alone. Aim of the present study was to assess the diagnostic gain in performing combined endoscopic and radiologic surveillance in the "high-risk" group compared to endoscopy alone in the "low-risk" one. There was no significant difference in terms of overall and disease-specific survivals between the two follow-up policies in spite of their different risk profiles. The same was true for organ preservation rate, which was 81% in the "high-risk" and 89% in the "low-risk" group. In contrast, the cumulative probability of disease-free survival was 54% for Group A and 65% for Group B (p = 0.0023). Therefore, our combined endoscopy and imaging surveillance protocol allowed increasing the submucosal recurrence detection rate in "high-risk" pT2-pT3 glottic SCC to 43%. An earlier detection of submucosal recurrences made salvage surgery by TLM feasible in at least half of cases, thus closing the gap between oncologic outcomes obtained in "high-"- vs. "low-risk" patients and leading to organ preservation rates that are favorably comparable to those obtained with open-neck partial laryngectomies and non-surgical organ preservation protocols | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Endoscopy | |
| 650 | 4 | |a Follow-up | |
| 650 | 4 | |a Glottic cancer | |
| 650 | 4 | |a Laryngeal cancer | |
| 650 | 4 | |a Magnetic resonance | |
| 650 | 4 | |a Transoral laser microsurgery | |
| 700 | 1 | |a Piazza, Cesare |e verfasserin |4 aut | |
| 700 | 1 | |a Ravanelli, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Gaggero, Giovanna |e verfasserin |4 aut | |
| 700 | 1 | |a Parrinello, Giampiero |e verfasserin |4 aut | |
| 700 | 1 | |a Paderno, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Perotti, Pietro |e verfasserin |4 aut | |
| 700 | 1 | |a Filauro, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Maroldi, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Peretti, Giorgio |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |d 1994 |g 274(2017), 10 vom: 18. Okt., Seite 3679-3686 |w (DE-627)NLM012637548 |x 1434-4726 |7 nnns |
| 773 | 1 | 8 | |g volume:274 |g year:2017 |g number:10 |g day:18 |g month:10 |g pages:3679-3686 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1007/s00405-017-4642-4 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 274 |j 2017 |e 10 |b 18 |c 10 |h 3679-3686 | ||