Current Role of Total Laryngectomy in the Era of Organ Preservation

Cancers
Alexandre BozecOlivier Dassonville

Abstract

In this article, we aimed to discuss the role of total laryngectomy (TL) in the management of patients with larynx cancer (LC) in the era of organ preservation. Before the 1990s, TL followed by radiotherapy (RT) was the standard treatment for patients with locally advanced LC. Over the last 30 years, various types of larynx preservation (LP) programs associating induction or concurrent chemotherapy (CT) with RT have been developed, with the aim of treating locally advanced LC patients while preserving the larynx and its functions. Overall, more than two-thirds of patients included in a LP program will not require total laryngectomy (TL) and will preserve a functional larynx. However, despite these advances, the larynx is the only tumor site in the upper aero-digestive tract for which prognosis has not improved during recent decades. Indeed, none of these LP protocols have shown any survival advantage compared to primary radical surgery, and it appears that certain LC patients do not benefit from an LP program. This is the case for patients with T4a LC (extra-laryngeal tumor extension through the thyroid cartilage) or with poor pretreatment laryngeal function and for whom primary TL is still the preferred therapeutic option. Mor...Continue Reading

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Citations

Aug 19, 2020·Journal of Cancer Research and Clinical Oncology·Arne BöttcherNikolaus Möckelmann
Jan 25, 2021·Acta otorrinolaringológica española·Laura Acevedo OrtizFrancisco Javier Galindo Ortego
Mar 27, 2021·European Annals of Otorhinolaryngology, Head and Neck Diseases·E HallidayS F Ahsan
Apr 20, 2021·Journal of Biomedical Materials Research. Part B, Applied Biomaterials·Zaid Al-QurayshiAliasger K Salem
Aug 28, 2021·Biomedicines·Dan Cristian GheorgheAlexandru Mihai Grumezescu
Oct 1, 2021·JAMA Otolaryngology-- Head & Neck Surgery·Blaine D SmithNosayaba Osazuwa-Peters

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NCT03340896

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