Primary Surgical and Non-surgical Treatment of Advanced Stage Laryngeal and Hypopharyngeal Carcinomas

In the past two decades, according to studies published in the early ’90s, the standard treatment of advanced laryngeal and hypopharyngeal carcinomas has been changed: instead of radical surgery, larynx-preserving methods came into view. To evaluate our results with this new approach we conducted a retrospective study summarizing the treatment data of the patients who received non-surgical (n=44) or surgical (n=207) therapy for their advanced, resectable laryngeal or hypopharyngeal cancer in the National Institute of Oncology between 2002 and 2007. Non-surgical treatment consisted of platinum base chemoradiotherapy plus salvage surgery if needed, while surgical treatment patients underwent laryngectomy with or without neck dissection followed by radiotherapy or chemoradiotherapy. With non-surgical treatment, the one-year laryngoesophageal dysfunction (LED) free survival (the patient is alive with functioning larynx without local relapse, tracheostomy or feeding tube) is 82.9% (SD=0.0592), at 24 months 79.8% (SD=0.0645). Non-surgical treatment proved to be beneficial regarding distant metastases as well (9.09% in non-surgical and 27.08% in surgical group at two years, respectively). Formation of a second primary tumor was more frequent in the non-surgical group (11.36% vs 8.33%). There was no significant difference in overall survival between treatment groups when stratified according to primary tumor site and stage. The results of larynx preserving treatments conducted in our Institute are similar to those published in the literature, confirming this method as standard therapy in this group of patients.