Three-Dimensional Map of Isoprognostic Zones in Glottic Cancer Treated by Transoral Laser Microsurgery as a Unimodal Treatment Strategy
INTRODUCTION: The Union for International Cancer Control-American Joint Committee on Cancer TNM staging system for glottic squamous cell carcinoma (SCC) includes different types of lesions defined by the involvement of specific subsites in each T category. Our study aims to identify different subcategories according to tumor local extension and determine oncologic outcomes after treatment by transoral laser microsurgery (TLM) alone.
METHODS: We retrospectively evaluated 410 patients affected by previously untreated pT1-pT3 glottic SCC treated by TLM alone from January 2005 to December 2015 at the Departments of Otorhinolaryngology-Head and Neck Surgery, Universities of Genoa and Brescia, Italy. All patients had at least 2 years of follow-up. Clinical, radiological, surgical, and histopathological data were reviewed and tumors divided into six subcategories: I, pT1a not involving the anterior commissure (AC); II, pT1b involving the AC; III, pT2 extending superficially to the supraglottis or the subglottis; IV, pT2 infiltrating the vocal muscle; V, pT3 involving the anterior paraglottic space; VI, pT2 or pT3 with vertical extension across the AC with/without involvement of the pre-epiglottic space. Recurrence-free survival (RFS), local control with laser alone (LCL), and organ preservation (OP) were defined as the primary oncologic outcomes.
RESULTS: The 2, 5, and 10-year RFS for the entire series were 85.7, 80.3, and 73.8%, LCL rates 93.8, 92.1, and 89.6%, and OP rates 96.8, 95.9, and 93.5%, respectively. However, when comparing the rates of RFS, LCL, and OP for each subcategory, important differences emerged. In particular, subcategories V and VI showed a significantly increased risk of local recurrence [hazard ratio (HR) = 9.2 and 13.3, respectively]. These subcategories also had a significantly reduced probability to achieve LCL (HR: 73.6 and 93.5, respectively) and OP (HR: 6.4 and 8.1, respectively).
CONCLUSION: The present classification in subcategories allows introducing the concept of a three-dimensional map of isoprognostic zones in glottic SCC treated by TLM alone as a useful tool in its management by a multidisciplinary tumor board.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2018 |
|---|---|
| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:8 |
|---|---|
| Enthalten in: |
Frontiers in oncology - 8(2018) vom: 06., Seite 175 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Piazza, Cesare [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Carbon dioxide laser |
|---|
| Anmerkungen: |
Date Revised 17.03.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.3389/fonc.2018.00175 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM285175564 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM285175564 | ||
| 003 | DE-627 | ||
| 005 | 20231226195132.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2018 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3389/fonc.2018.00175 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0950.xml |
| 035 | |a (DE-627)NLM285175564 | ||
| 035 | |a (NLM)29872643 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Piazza, Cesare |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Three-Dimensional Map of Isoprognostic Zones in Glottic Cancer Treated by Transoral Laser Microsurgery as a Unimodal Treatment Strategy |
| 264 | 1 | |c 2018 | |
| 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 Revised 17.03.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a INTRODUCTION: The Union for International Cancer Control-American Joint Committee on Cancer TNM staging system for glottic squamous cell carcinoma (SCC) includes different types of lesions defined by the involvement of specific subsites in each T category. Our study aims to identify different subcategories according to tumor local extension and determine oncologic outcomes after treatment by transoral laser microsurgery (TLM) alone | ||
| 520 | |a METHODS: We retrospectively evaluated 410 patients affected by previously untreated pT1-pT3 glottic SCC treated by TLM alone from January 2005 to December 2015 at the Departments of Otorhinolaryngology-Head and Neck Surgery, Universities of Genoa and Brescia, Italy. All patients had at least 2 years of follow-up. Clinical, radiological, surgical, and histopathological data were reviewed and tumors divided into six subcategories: I, pT1a not involving the anterior commissure (AC); II, pT1b involving the AC; III, pT2 extending superficially to the supraglottis or the subglottis; IV, pT2 infiltrating the vocal muscle; V, pT3 involving the anterior paraglottic space; VI, pT2 or pT3 with vertical extension across the AC with/without involvement of the pre-epiglottic space. Recurrence-free survival (RFS), local control with laser alone (LCL), and organ preservation (OP) were defined as the primary oncologic outcomes | ||
| 520 | |a RESULTS: The 2, 5, and 10-year RFS for the entire series were 85.7, 80.3, and 73.8%, LCL rates 93.8, 92.1, and 89.6%, and OP rates 96.8, 95.9, and 93.5%, respectively. However, when comparing the rates of RFS, LCL, and OP for each subcategory, important differences emerged. In particular, subcategories V and VI showed a significantly increased risk of local recurrence [hazard ratio (HR) = 9.2 and 13.3, respectively]. These subcategories also had a significantly reduced probability to achieve LCL (HR: 73.6 and 93.5, respectively) and OP (HR: 6.4 and 8.1, respectively) | ||
| 520 | |a CONCLUSION: The present classification in subcategories allows introducing the concept of a three-dimensional map of isoprognostic zones in glottic SCC treated by TLM alone as a useful tool in its management by a multidisciplinary tumor board | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a carbon dioxide laser | |
| 650 | 4 | |a glottic cancer | |
| 650 | 4 | |a laryngeal cancer | |
| 650 | 4 | |a oncologic outcomes | |
| 650 | 4 | |a prognosis | |
| 650 | 4 | |a transoral laser microsurgery | |
| 700 | 1 | |a Filauro, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Paderno, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Marchi, Filippo |e verfasserin |4 aut | |
| 700 | 1 | |a Perotti, Pietro |e verfasserin |4 aut | |
| 700 | 1 | |a Morello, Riccardo |e verfasserin |4 aut | |
| 700 | 1 | |a Taboni, Stefano |e verfasserin |4 aut | |
| 700 | 1 | |a Parrinello, Giampiero |e verfasserin |4 aut | |
| 700 | 1 | |a Incandela, Fabiola |e verfasserin |4 aut | |
| 700 | 1 | |a Iandelli, Andrea |e verfasserin |4 aut | |
| 700 | 1 | |a Missale, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Peretti, Giorgio |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Frontiers in oncology |d 2011 |g 8(2018) vom: 06., Seite 175 |w (DE-627)NLM218189583 |x 2234-943X |7 nnns |
| 773 | 1 | 8 | |g volume:8 |g year:2018 |g day:06 |g pages:175 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3389/fonc.2018.00175 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 8 |j 2018 |b 06 |h 175 | ||