Prognostic factors for survival after salvage total laryngectomy following radiotherapy or chemoradiation failure: a 10-year retrospective longitudinal study in eastern Denmark

N B Wulff; E Andersen; C A Kristensen; C H Sørensen; B Charabi; P Homøe

doi:10.1111/coa.12726

Prognostic factors for survival after salvage total laryngectomy following radiotherapy or chemoradiation failure: a 10-year retrospective longitudinal study in eastern Denmark

N B Wulff, E Andersen, C A Kristensen, C H Sørensen, B Charabi, P Homøe

Institut for Klinisk Medicin

15 Citationer (Scopus)

Abstract

OBJECTIVE: The primary aims were to determine the rates of and prognostic factors for overall survival, disease-specific survival and disease-free survival following salvage total laryngectomy.

DESIGN: Retrospective longitudinal study.

SETTING: Tertiary medical centres.

PARTICIPANTS: A total of 142 patients in eastern Denmark undergoing salvage total laryngectomy for squamous cell carcinoma of the larynx or hypopharynx.

MAIN OUTCOME MEASURES: 5-year overall survival, 5-year disease-specific survival, 5-year disease-free survival and prognostic factors for these outcomes.

RESULTS: 5-year overall survival, disease-specific survival and disease-free survival were 37.7%, 54.9% and 55.3%, respectively. N classification at primary diagnosis, lymph node excision and postoperative complications within 1 year after salvage total laryngectomy were prognostic factors for shorter overall survival, disease-specific survival and disease-free survival. Residual tumour/recurrence was negatively associated with overall survival, close or involved resection margins with disease-specific survival, and second primary cancer was associated with longer disease-specific survival and disease-free survival. Nine per cent of all patients had residual tumour and 33.8% developed a recurrence.

CONCLUSION: Our overall survival, disease-specific survival and disease-free survival findings are in accordance with previous studies. With the purpose of identifying recurrent tumour, we suggest extra attention being given to patients with higher N classification and need for lymph node excision during salvage total laryngectomy along with use of frozen sections. The high number of patients with recurrence within 1 year after salvage total laryngectomy occurred although thorough and regular follow-up visits were performed.

Originalsprog	Engelsk
Tidsskrift	Clinical Otolaryngology
Vol/bind	42
Udgave nummer	2
Sider (fra-til)	336-346
ISSN	1749-4478
DOI	https://doi.org/10.1111/coa.12726
Status	Udgivet - 1 apr. 2017

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10.1111/coa.12726

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Prognostic factors for survival after salvage total laryngectomy following radiotherapy or chemoradiation failure : a 10-year retrospective longitudinal study in eastern Denmark. / Wulff, N B; Andersen, E; Kristensen, C A et al.

I: Clinical Otolaryngology, Bind 42, Nr. 2, 01.04.2017, s. 336-346.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

@article{b345f7499b864efaa0c9116e29749b79,

title = "Prognostic factors for survival after salvage total laryngectomy following radiotherapy or chemoradiation failure: a 10-year retrospective longitudinal study in eastern Denmark",

abstract = "OBJECTIVE: The primary aims were to determine the rates of and prognostic factors for overall survival, disease-specific survival and disease-free survival following salvage total laryngectomy.DESIGN: Retrospective longitudinal study.SETTING: Tertiary medical centres.PARTICIPANTS: A total of 142 patients in eastern Denmark undergoing salvage total laryngectomy for squamous cell carcinoma of the larynx or hypopharynx.MAIN OUTCOME MEASURES: 5-year overall survival, 5-year disease-specific survival, 5-year disease-free survival and prognostic factors for these outcomes.RESULTS: 5-year overall survival, disease-specific survival and disease-free survival were 37.7%, 54.9% and 55.3%, respectively. N classification at primary diagnosis, lymph node excision and postoperative complications within 1 year after salvage total laryngectomy were prognostic factors for shorter overall survival, disease-specific survival and disease-free survival. Residual tumour/recurrence was negatively associated with overall survival, close or involved resection margins with disease-specific survival, and second primary cancer was associated with longer disease-specific survival and disease-free survival. Nine per cent of all patients had residual tumour and 33.8% developed a recurrence.CONCLUSION: Our overall survival, disease-specific survival and disease-free survival findings are in accordance with previous studies. With the purpose of identifying recurrent tumour, we suggest extra attention being given to patients with higher N classification and need for lymph node excision during salvage total laryngectomy along with use of frozen sections. The high number of patients with recurrence within 1 year after salvage total laryngectomy occurred although thorough and regular follow-up visits were performed.",

keywords = "Aged, Carcinoma, Squamous Cell/surgery, Chemoradiotherapy, Denmark, Female, Humans, Laryngeal Neoplasms/surgery, Laryngectomy/methods, Longitudinal Studies, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Factors, Salvage Therapy, Survival Rate, Treatment Failure",

author = "Wulff, {N B} and E Andersen and Kristensen, {C A} and S{\o}rensen, {C H} and B Charabi and P Hom{\o}e",

note = "{\textcopyright} 2016 John Wiley & Sons Ltd.",

year = "2017",

month = apr,

day = "1",

doi = "10.1111/coa.12726",

language = "English",

volume = "42",

pages = "336--346",

journal = "Clinical Otolaryngology",

issn = "1749-4478",

publisher = "Wiley-Blackwell",

number = "2",

}

TY - JOUR

T1 - Prognostic factors for survival after salvage total laryngectomy following radiotherapy or chemoradiation failure

T2 - a 10-year retrospective longitudinal study in eastern Denmark

AU - Wulff, N B

AU - Andersen, E

AU - Kristensen, C A

AU - Sørensen, C H

AU - Charabi, B

AU - Homøe, P

PY - 2017/4/1

Y1 - 2017/4/1

N2 - OBJECTIVE: The primary aims were to determine the rates of and prognostic factors for overall survival, disease-specific survival and disease-free survival following salvage total laryngectomy.DESIGN: Retrospective longitudinal study.SETTING: Tertiary medical centres.PARTICIPANTS: A total of 142 patients in eastern Denmark undergoing salvage total laryngectomy for squamous cell carcinoma of the larynx or hypopharynx.MAIN OUTCOME MEASURES: 5-year overall survival, 5-year disease-specific survival, 5-year disease-free survival and prognostic factors for these outcomes.RESULTS: 5-year overall survival, disease-specific survival and disease-free survival were 37.7%, 54.9% and 55.3%, respectively. N classification at primary diagnosis, lymph node excision and postoperative complications within 1 year after salvage total laryngectomy were prognostic factors for shorter overall survival, disease-specific survival and disease-free survival. Residual tumour/recurrence was negatively associated with overall survival, close or involved resection margins with disease-specific survival, and second primary cancer was associated with longer disease-specific survival and disease-free survival. Nine per cent of all patients had residual tumour and 33.8% developed a recurrence.CONCLUSION: Our overall survival, disease-specific survival and disease-free survival findings are in accordance with previous studies. With the purpose of identifying recurrent tumour, we suggest extra attention being given to patients with higher N classification and need for lymph node excision during salvage total laryngectomy along with use of frozen sections. The high number of patients with recurrence within 1 year after salvage total laryngectomy occurred although thorough and regular follow-up visits were performed.

AB - OBJECTIVE: The primary aims were to determine the rates of and prognostic factors for overall survival, disease-specific survival and disease-free survival following salvage total laryngectomy.DESIGN: Retrospective longitudinal study.SETTING: Tertiary medical centres.PARTICIPANTS: A total of 142 patients in eastern Denmark undergoing salvage total laryngectomy for squamous cell carcinoma of the larynx or hypopharynx.MAIN OUTCOME MEASURES: 5-year overall survival, 5-year disease-specific survival, 5-year disease-free survival and prognostic factors for these outcomes.RESULTS: 5-year overall survival, disease-specific survival and disease-free survival were 37.7%, 54.9% and 55.3%, respectively. N classification at primary diagnosis, lymph node excision and postoperative complications within 1 year after salvage total laryngectomy were prognostic factors for shorter overall survival, disease-specific survival and disease-free survival. Residual tumour/recurrence was negatively associated with overall survival, close or involved resection margins with disease-specific survival, and second primary cancer was associated with longer disease-specific survival and disease-free survival. Nine per cent of all patients had residual tumour and 33.8% developed a recurrence.CONCLUSION: Our overall survival, disease-specific survival and disease-free survival findings are in accordance with previous studies. With the purpose of identifying recurrent tumour, we suggest extra attention being given to patients with higher N classification and need for lymph node excision during salvage total laryngectomy along with use of frozen sections. The high number of patients with recurrence within 1 year after salvage total laryngectomy occurred although thorough and regular follow-up visits were performed.

KW - Aged

KW - Carcinoma, Squamous Cell/surgery

KW - Chemoradiotherapy

KW - Denmark

KW - Female

KW - Humans

KW - Laryngeal Neoplasms/surgery

KW - Laryngectomy/methods

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Retrospective Studies

KW - Risk Factors

KW - Salvage Therapy

KW - Survival Rate

KW - Treatment Failure

U2 - 10.1111/coa.12726

DO - 10.1111/coa.12726

M3 - Journal article

C2 - 27537427

SN - 1749-4478

VL - 42

SP - 336

EP - 346

JO - Clinical Otolaryngology

JF - Clinical Otolaryngology

IS - 2

ER -

Prognostic factors for survival after salvage total laryngectomy following radiotherapy or chemoradiation failure: a 10-year retrospective longitudinal study in eastern Denmark

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