School of Medicine and Health Sciences Poster Presentations

Title

Transoral Supraglottic Resection and Neck Dissection in Definitive Management of Supraglottic Squamous Cell Carcinoma

Poster Number

144

Document Type

Poster

Publication Date

3-2016

Abstract

Introduction: Major advances have come about in the treatment of laryngeal carcinoma with the utilization of transoral approaches. These approaches include transoral laser microsurgery (TLM) and transoral robotic surgery (TORS). These methods are less invasive than the traditional open neck surgical approach. The aim of this retrospective study was to determine the efficacy of TLM and TORS in the treatment of supraglottic squamous cell carcinoma.

Methods. This is a retrospective study of 19 patients with supraglottic squamous cell carcinoma managed with transoral surgery and neck dissection. The study patients were classified as follows: 1 (5.3%) stage I, 1 (5.3%) stage II, 11 (57.9%), stage III, and 6 (31.6%) stage IV. Neck dissection was done on 16 out of the 19 patients. Three patients did not undergo neck dissection, 2 for early stage (T1N0, T2N0), and the third, (T4Nx), for multiple comorbidities precluding neck dissection with prolonged general anesthesia. Three patients (15.8%) received adjuvant radiation. Adjuvant radiotherapy was given in 2 cases for advanced neck disease with multiple metastatic nodes (T3N2b and T2N2c), and in 1 for advanced T stage and management of the neck (T4Nx) because neck dissection was not done.

Results. The 3-year overall survival rate for all patients included in the study was 77.4%. The 3-year disease specific survival rate was 94.7%. The 3-year distant metastasis-free survival was 70.4%.

Conclusion. The results of this study show that transoral partial or complete supraglottic laryngectomy and neck dissection with adjuvant radiotherapy in select cases is an effective means of treating supraglottic squamous cell carcinoma. These outcomes are comparable to historically reported survival outcomes assessing the efficacy of transoral surgical approaches for supraglottic carcinoma and are also comparable and better than historically reported survival outcomes for non-surgical management of supraglottic cancer with radiation therapy.

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Presented at: GW Research Days 2016

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Transoral Supraglottic Resection and Neck Dissection in Definitive Management of Supraglottic Squamous Cell Carcinoma

Introduction: Major advances have come about in the treatment of laryngeal carcinoma with the utilization of transoral approaches. These approaches include transoral laser microsurgery (TLM) and transoral robotic surgery (TORS). These methods are less invasive than the traditional open neck surgical approach. The aim of this retrospective study was to determine the efficacy of TLM and TORS in the treatment of supraglottic squamous cell carcinoma.

Methods. This is a retrospective study of 19 patients with supraglottic squamous cell carcinoma managed with transoral surgery and neck dissection. The study patients were classified as follows: 1 (5.3%) stage I, 1 (5.3%) stage II, 11 (57.9%), stage III, and 6 (31.6%) stage IV. Neck dissection was done on 16 out of the 19 patients. Three patients did not undergo neck dissection, 2 for early stage (T1N0, T2N0), and the third, (T4Nx), for multiple comorbidities precluding neck dissection with prolonged general anesthesia. Three patients (15.8%) received adjuvant radiation. Adjuvant radiotherapy was given in 2 cases for advanced neck disease with multiple metastatic nodes (T3N2b and T2N2c), and in 1 for advanced T stage and management of the neck (T4Nx) because neck dissection was not done.

Results. The 3-year overall survival rate for all patients included in the study was 77.4%. The 3-year disease specific survival rate was 94.7%. The 3-year distant metastasis-free survival was 70.4%.

Conclusion. The results of this study show that transoral partial or complete supraglottic laryngectomy and neck dissection with adjuvant radiotherapy in select cases is an effective means of treating supraglottic squamous cell carcinoma. These outcomes are comparable to historically reported survival outcomes assessing the efficacy of transoral surgical approaches for supraglottic carcinoma and are also comparable and better than historically reported survival outcomes for non-surgical management of supraglottic cancer with radiation therapy.