Belgium; Combined Modality Therapy/standards; France; Glottis; Humans; Laryngeal Neoplasms/pathology; Laryngeal Neoplasms/therapy; Male; Middle Aged; Surveys and Questionnaires; Switzerland; Disease Management; Neoplasm Staging; Practice Guidelines as Topic; Cancer; Endoscopic surgery; Head and neck; Larynx; Radiotherapy; Combined Modality Therapy; Laryngeal Neoplasms; Questionnaires; Otorhinolaryngology; General Medicine
Abstract :
[en] The aim of this study was to evaluate the practices of ENT surgeons for the management of early glottic cancers affecting only one vocal cord, i.e. classified T1a. A questionnaire was sent to different surgeons managing cancers of the larynx in France, Belgium and Switzerland. A descriptive and comparative analysis of practices across centers was performed. The decision-making parameters of the therapeutic strategy were analyzed. Sixty-nine surgeons completed the questionnaire (58 in France, 10 in Belgium and one in Switzerland). In the example of a 50-year-old man with active tobacco use and no oncologic history presenting a squamous cell carcinoma of the middle third of the vocal cord classified T1aN0M0, and with easy glottic exposition by laryngoscopy, 91 % of surgeons proposed endoscopic surgery laser, 2 % radiotherapy and 7 % proposed one of these two treatments without any preference. Therapeutic strategies were not influenced by the sex (p = 1.00), the smoking status (p = 0.58) or the age of the patient (more or less than 80 years, p = 0.27). A significant change was observed in the therapeutic strategy for tumors non-exposable by laryngoscopy (p = 0.032), tumors reaching the anterior commissure (p = 0.001) and patients using their voice professionally (p = 0.0003). The management strategy of T1a glottic carcinomas, in our series, is mainly surgical. The choice of therapeutic strategy seems to be based, in our series, on criteria such as the risk of a second location, cost, and duration of treatment.
Disciplines :
Otolaryngology
Author, co-author :
Fakhry, Nicolas; Service d'ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM)/Aix-Marseille Univ, Centre Hospitalier Universitaire la Timone, 264 rue Saint Pierre, 13385, Marseille Cedex 05, France, nicolas.fakhry@ap-hm.fr
Vergez, Sébastien; Service d’ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire Rangueil-Larrey, Toulouse Cedex 09, France
Baumstarck, Karine; Unité d’Aide Méthodologique à la Recherche Clinique, Assistance Publique-Hôpitaux de Marseille, Centre Hospitalier Universitaire La Timone, Marseille Cedex 05, France ; EA 3279 ‘Qualité de Vie Concepts, Usages et Limites Déterminants’ Aix-Marseille Université, Marseille Cedex, France
Lagier, Aude ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'ORL, d'audiophonologie et de chir. cervico-faciale ; Service d’ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM)/Aix–Marseille Univ, Centre Hospitalier Universitaire la Timone, Marseille Cedex 05, France ; LPL, Laboratoire Parole et Langage, CNRS UMR 7309, Aix-Marseille Univ, Aix en Provence, France
Santini, Laure; Service d’ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM)/Aix–Marseille Univ, Centre Hospitalier Universitaire la Timone, Marseille Cedex 05, France ; LPL, Laboratoire Parole et Langage, CNRS UMR 7309, Aix-Marseille Univ, Aix en Provence, France
Dessi, Patrick; Service d’ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM)/Aix–Marseille Univ, Centre Hospitalier Universitaire la Timone, Marseille Cedex 05, France
Babin, Emmanuel; Service d’ORL et Chirurgie Cervico-Faciale, CHU Côte de Nacre, Caen Cedex 9, France
Giovanni, Antoine; Service d’ORL et Chirurgie Cervico-Faciale, Assistance Publique-Hôpitaux de Marseille (AP-HM)/Aix–Marseille Univ, Centre Hospitalier Universitaire la Timone, Marseille Cedex 05, France ; LPL, Laboratoire Parole et Langage, CNRS UMR 7309, Aix-Marseille Univ, Aix en Provence, France
Language :
English
Title :
Multicentric evaluation of strategies for treatment of T1a glottic carcinomas.
Remmelts AJ, Hoebers FJ, Klop WM, Balm AJ, Hamming-Vrieze O, van den Brekel MW (2013) Evaluation of laser surgery and radiotherapy as treatment modalities in early stage laryngeal carcinoma: tumour outcome and quality of voice. Eur Arch Otorhinolaryngol 270(7):2079–2087
Higgins KM, Shah MD, Ogaick MJ, Enepekides D (2009) Treatment of early-stage glottic cancer: meta-analysis comparison of laser excision versus radiotherapy. J Otolaryngol Head Neck Surg 38:603–612
Dey P, Arnold D, Wight R, MacKenzie K, Kelly C, Wilson J (2002) Radiotherapy versus open surgery versus endolaryngeal surgery (with or without laser) for early laryngeal squamous cell cancer. Cochrane Database Syst Rev (2):1–18
Yoo J, Lacchetti C, Hammond JA, Gilbert RW, Head and Neck Cancer Disease Site Group (2013) Role of endolaryngeal surgery (with or without laser) compared with radiotherapy in the management of early (T1) glottic cancer: a clinical practice guideline. Curr Oncol 20:e132–e135
Cuny F, Géry B, Florescu C et al (2013) Exclusive radiotherapy for stage T1-T2N0M0 lanryngeal cancer: retrospective study of 59 patients at CFB and CHU de Caen. Eur Ann Otorhinolaryngol Head Neck Dis 130:251–256
Rydell R, Schalén L, Fex S, Elner A (1995) Voice evaluation before and after laser excision vs. radiotherapy of T1A glottic carcinoma. Acta Otolaryngol 115:560–565
Jones AS, Fish B, Fenton JE, Husband DJ (2004) The treatment of early laryngeal cancers (T1-T2 N0): surgery or irradiation? Head Neck 26:127–135
van Gogh CD, Verdonck-de Leeuw IM, Wedler-Peeters J, Langendijk JA, Mahieu HF (2012) Prospective evaluation of voice outcome during the first two years in male patients treated by radiotherapy or laser surgery for T1a glottic carcinoma. Eur Arch Otorhinolaryngol 269(6):1647–1652
Peeters AJ, van Gogh CD, Goor KM (2004) Verdonck-de Leeuw IM, Langendijk JA, Mahieu HF. Health status and voice outcome after treatment for T1a glottic carcinoma. Eur Arch Otorhinolaryngol 261:534–540
Cohen SM, Garrett CG, Dupont WD, Ossoff RH, Courey MS (2006) Voice-related quality of life in T1 glottic cancer: irradiation versus endoscopic excision. Ann Otol Rhinol Laryngol 115:581–586
Spielmann PM, Majumdar S, Morton RP (2010) Quality of life and functional outcomes in the management of early glottic carcinoma: a systematic review of studies comparing radiotherapy and transoral laser microsurgery. Clin Otolaryngol 35:373–382
Mendenhall WM, Werning JW, Hinerman RW, Amdur RJ, Villaret DB (2004) Management of T1-T2 glottic carcinomas. Cancer 100:1786–1792
Thurnher D, Erovic BM, Frommlet F et al (2008) Challenging a dogma–surgery yields superior long-term results for T1a squamous cell carcinoma of the glottic larynx compared to radiotherapy. Eur J Surg Oncol 34:692–698
Schrijvers ML, van Riel EL, Langendijk JA, Dikkers FG, Schuuring E, van der Wal JE, van der Laan BF (2009) Higher laryngeal preservation rate after CO2 laser surgery compared with radiotherapy in T1a glottic laryngeal carcinoma. Head Neck 31:759–764
Suárez C, Rodrigo JP, Silver CE et al (2012) Laser surgery for early to moderately advanced glottic, supraglottic, and hypopharyngeal cancers. Head Neck 34:1028–1035
Farhadieh RD, Salardini A, Yang JL, Russell P, Smee R (2010) Diagnosis of second head and neck tumors in primary laryngeal SCC is an indicator of overall survival and not associated with poorer overall survival: a single centre study in 987 patients. J Surg Oncol 101:72–77
Higgins KM (2011) What treatment for early-stage glottic carcinoma among adult patients: CO2 endolaryngeal laser excision versus standard fractionated external beam radiation is superior in terms of cost utility? Laryngoscope 121:116–134
Goor KM, Peeters AJ, Mahieu HF, Langendijk JA, Leemans CR (2007) Verdonck-de Leeuw IM, van Agthoven M. Cordectomy by CO2 laser or radiotherapy for small T1a glottic carcinomas: costs, local control, survival, quality of life, and voice quality. Head Neck 29:128–136
de Campora E, Radici M, de Campora L (2001) External versus endoscopic approach in the surgical treatment of glottic cancer. Eur Arch Otorhinolaryngol 258(10):533–536
Silver CE, Beitler JJ, Shaha AR, Rinaldo A, Ferlito A (2009) Current trends in initial management of laryngeal cancer: the declining use of open surgery. Eur Arch Otorhinolaryngol 266:1333–1352
Karatzanis AD, Psychogios G, Zenk J, Waldfahrer F, Hornung J, Velegrakis GA, Iro H (2009) Comparison among different available surgical approaches in T1 glottic cancer. Laryngoscope 119:1704–1708
Rödel RM, Steiner W, Müller RM, Kron M, Matthias C (2009) Endoscopic laser surgery of early glottic cancer: involvement of the anterior commissure. Head Neck 31:583–592
Steiner W, Ambrosch P, Rödel RM, Kron M (2004) Impact of anterior commissure involvement on local control of early glottic carcinoma treated by laser microresection. Laryngoscope 114(8):1485–1491
Taylor SM, Kerr P, Fung K et al (2013) Treatment of T1b glottic SCC: laser vs. radiation—a Canadian multicenter study. J Otolaryngol Head Neck Surg 42:22
Tong CC, Au KH, Ngan RK et al (2011) Impact and relationship of anterior commissure and time–dose factor on the local control of T1N0 glottic cancer treated by 6 MV photons. Radiat Oncol 6:53
Szyfter W, Leszczyńska M, Wierzbicka M, Kopeć T, Bartochowska A (2013) Value of open horizontal glottectomy in the treatment for T1b glottic cancer with anterior commissure involvement. Head Neck 35:1738–1744
Fakhry N, Michel J, Giorgi R et al (2013) Analysis of swallowing after partial frontolateral laryngectomy with epiglottic reconstruction for glottic cancer. Eur Arch Otorhinolaryngol. doi:10.1007/s00405-013-2750-3
Giovanni A, Guelfucci B, Gras R, Yu P, Zanaret M (2001) Partial frontolateral laryngectomy with epiglottic reconstruction for management of early-stage glottic carcinoma. Laryngoscope 111(4 Pt 1):663–668
Makeieff M, de la Breteque A, Guerrier B, Giovanni A (2009) Voice handicap evaluation after supracricoid partial laryngectomy. Laryngoscope 119(4):746–750
van Gogh CD, Verdonck-de Leeuw IM, Boon-Kamma BA et al (2006) The efficacy of voice therapy in patients after treatment for early glottic carcinoma. Cancer 106:95–105
