期刊
JOURNAL OF PERSONALIZED MEDICINE
卷 12, 期 10, 页码 -出版社
MDPI
DOI: 10.3390/jpm12101585
关键词
laryngeal cancer; squamous cell carcinoma; head and neck; radiological assessment; fibro endoscopy; laryngectomy; histopathology; tumor board; open partial horizontal laryngectomy; OPHL; endoscopic supraglottic laryngectomy; eHSL; total laryngectomy
Endoscopy and morphological imaging play a crucial role in the diagnostic work-up of LSCCs. Multidisciplinary integration of different staging methods can provide a shared pretreatment staging for accurate prediction of tumor characteristics. Surgical resection with preservation of laryngeal function shows favorable oncological outcomes.
(1) Background: Endoscopy and morphological imaging are the mainstay of the diagnostic work up of laryngeal squamous cell carcinomas (LSCCs), which can be integrated in a multidisciplinary discussion to obtain a shared pretreatment staging. (2) Methods: A retrospective evaluation of patients, managed at a tertiary university hospital in Italy and submitted to major laryngeal surgery, has been performed. Four different stagings have been defined and compared: epTN (based on endoscopy and physical ENT examination); radTN (based on CT scan); cTN (based on multidisciplinary integration of the two above); pTN based on pathology on surgical samples. Oncological outcomes have been assessed. (3) Results: Three-year relapse free and disease specific survival were 88% and 92.5%, respectively, without significant differences between partial surgeries (n = 13) and total laryngectomies (n = 32). As for the pretreatment staging, and in particular the T classification, the cTN has been revealed as more reliable than epTN and radTN alone in predicting the final pT (Cohen kappa coefficient: 0.7 for cT, 0.44 for radT, 0.32 for epT). In the partial surgery group, we did not record any positive margin nor local recurrence, with a 100% overall and disease-specific survival. (4) Conclusions: The multidisciplinary approach is fundamental in the definition of the primary lesion in LSCC, in particular in order to safely perform surgical preservation of laryngeal function, which is associated with a higher laryngectomy-free survival than irradiation but to a lower salvageability in case of recurrence.
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