Clinicopathological Evaluation and Survival Rate of Advanced Laryngeal Malignancy (t3, t4) Managed with Widefield total/near total Laryngectomy with Neck Dissection

Nayak, Dipak Ranjan and Balakrishnan, R and Deichu, Mudaiah and Nair, Suraj and Hazarika, P and Lewis, Melissa Glenda (2015) Clinicopathological Evaluation and Survival Rate of Advanced Laryngeal Malignancy (t3, t4) Managed with Widefield total/near total Laryngectomy with Neck Dissection. Odisha Journal of Otorhinolaryngology and HNS, 9 (2). pp. 14-19. ISSN 0974 - 5262

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Abstract

Objective: : This is a study of clincopathological features and outcome of surgical management with 3 years survival pattern following total! near total laryngectomy in advanced III,IV squamous cell carcinoma larynx. Methods: Retrospective observational study conducted between January 2000 to December 2013. with 87 patients of biopsy proved squamous cell carcinoma of larynx in advanced stage T3&T4. Radio residual cases were also included in the study. 79 patients were treated surgically with Wide field total laryngectomy and 8 with near total laryngectomy along with bilateral neck dissection. Average follow up period was 15 months postoperative. All cases received post op radiotherapy except the radio-residual cases which were managed with salvage surgery alone. Chemotherapy was added in 7 cases due to extra-capsular metastasis.. Data was analyzed using Kaplan Meier method of estimation to estimate the median survival time wherever applicable. Statistical analysis was carried out using STAT A D.Results: The a e range was 40 years to 85 years. The maximum incidence was found in 6lh and 7lh decade. 84% of the total patients were male. About 69/87 (79.31 %) were smokers. 51187 (58.6%) were T3, 36/87(41.4%) were T4 lesions. 42/87(48.27%) were NO , 30/87(34.48%) were N1 and 15/87(17.2%) were N2lesions . Overall incidence of nodal metastasis was 51.7%. 71 % of the supraglottic carcinomas had nodal metastasis at time of presentation and 44% of glottis tumors had nodal metastasis. There were no cases of distant metastasis. Topographical Distribution showed 46% were glottic lesions, 35.6% were supraglottic lesions and 18.4% were transglottic lesions. 22/87(25.28%) were cases ofpost RT recurrence and the mean duration of recurrence was 21 months.65/87 cases who underwent the surgical intervention received radiotherapy3 to 4 weeks following surgery. 22/ 87 radio residual cases underwent salvage surgery. This study showed overall survival rate of 87.3% and disease specific survival rate at 3 years to be 86] % for all stage I I, IV laryngeal carcinoma who underwent wide field total laryngectomy/near total laryngectomy.Conclusions: This study demonstrates the overall survival and 3 year specific disease free survival rates with Wide field total laryngectomy/ Near total laryngectomy in patients with stage III, IV laryngeal carcinoma.

Item Type: Article
Uncontrolled Keywords: Supraglottis; Glottis; Wide field laryngectomy; Near total laryngectomy
Subjects: Medicine > KMC Manipal > ENT
Depositing User: KMC Library
Date Deposited: 21 Apr 2016 08:59
Last Modified: 21 Apr 2016 08:59
URI: http://eprints.manipal.edu/id/eprint/145902

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