Clinical Outcomes of Supraglottic Laryngeal Cancer: Insights from a Decade of Surgical Treatment

Year 2024, Volume: 34 Issue: 1, 8 - 12, 27.03.2024

Yaşar Kemal Duymaz

https://doi.org/10.26650/Tr-ENT.2024.1387086

Abstract

Objective: This study sought to retrospectively examine the clinical outcomes of patients treated for supraglottic laryngeal cancer at a single center over a decade, assess the efficacy of surgical interventions, and evaluate survival rates in comparison to current literature.
Materials and Methods: A retrospective analysis was conducted on 84 patients diagnosed with supraglottic laryngeal cancer who underwent surgical treatment between January 2008 and December 2018. Nonlaryngeal head and neck malignancies and inaccessible patient records were excluded. The study evaluated factors including tumor location, tumor stage, lymph node metastasis, surgical approach, complications, histopathological findings, and adjuvant therapy. Statistical analysis involved descriptive methods, frequencies, and ratios, with outcomes compared to existing literature.
Results: The cohort primarily consisted of male patients (91.7%) with an average age of 58.04 years. Squamous cell carcinoma was the predominant histopathological type (98.8%), exhibiting various degrees of differentiation. Most patients presented with advanced-stage disease (III or IV), with 53.6% undergoing total laryngectomy. Neck dissection was performed in 95.2% of cases, and 69% received postoperative radiotherapy. The 5-year overall survival rate was 72.2%, with a recurrence rate of 7.1%.
Conclusion: This study reveals that supraglottic laryngeal cancer, predominantly affecting older males, is frequently diagnosed at advanced stages. Surgical intervention resulted in a 5-year survival rate consistent with existing literature. Despite the limitation of its retrospective design and the small, single-center sample, the findings support current treatment modalities while underscoring the importance of early detection and further research.

Keywords

Supraglottic laryngeal cancer, squamous cell carcinoma, neck dissection, total laryngectomy, partial laryngectomy

References

• 1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019;69(1):7-34. google scholar
• 2. Ciolofan MS, Vlâescu AN, Mogoantâ CA, lonitâ E, lonitâ I, Câpitânescu AN, et al. Clinical, histological and immunohistochemical evaluation of larynx cancer. Curr Heal Sci J 2017;43(4):367-75. google scholar
• 3. Hoffman HT, Porter K, Karnell LH, Cooper JS, Weber RS, Langer CJ, et al. Laryngeal cancer in the United States: changes in demographics, patterns of care, and survival. Laryngoscope 2006;116(9 Suppl 2):1-13. google scholar
• 4. Tufano RP. Organ preservation surgery for laryngeal cancer. Otolaryngol Clin North Am 2002;35(5):1067-80. google scholar
• 5. Bron LP, Soldati D, Monod ML, Megevand C, Brossard E, Monnier P, et al. Horizontal partial laryngectomy for supraglottic squamous cell carcinoma. Eur Arch Oto-Rhino-Laryngology 2005;262(4):302-6. google scholar
• 6. Weinstein GS, Laccourreye O, Brasnu D, Tucker J, Montone K. Reconsidering a paradigm- the spread of supraglottic carcinoma to glottis. Laryngoscope 1995;105(10):1129-33. google scholar
• 7. Myers EN, Alvi A. Management of carcinoma of the supraglottic larynx: Evolution, current concepts, and future trends. Laryngoscope 1996;106(5):559-67. google scholar
• 8. Spriano G, Piantanida R, Pellini R, Muscatello L. Elective treatment of the neck in squamous cell carcinoma of the larynx: Clinical experience. Head Neck 2003;25(2):97-102 google scholar
• 9. Redaelli De Zinis LO, Nicolai P, Tomenzoli D, Ghizzardi D, Trimarchi M, Cappiello J, et al. The distribution of lymph node metastases in supraglottic squamous cell carcinoma: therapeutic implications. Head Neck 2002;24(10):913-20. google scholar
• 10. Group BH. End results of a prospective trial on elective lateral neck dissection vs type III modified radical neck dissection in the management of supraglottic and transglottic carcinomas. Head Neck 1999;21(8):694-702. google scholar
• 11. De Stefani E, Boffetta P, Deneo-Pellegrini H, Brennan P, Correa P, Oreggia F, et al. Supraglottic and glottic carcinomas: epidemiologically distinct entities? Int J Cancer 2004;112(6):1065-71. google scholar
• 12. Hashibe M, Boffetta P, Zaridze D, Shangina O, Szeszenia-Dabrowska N, Mates D, et al. Contribution of tobacco and alcohol to the high rates of squamous cell carcinoma of the supraglottis and glottis in Central Europe. Am J Epidemiol 2007;165(7):814-20. google scholar
• 13. Patel TD, Echanique KA, Yip C, Hsueh WD, Baredes S, Park RCW, et al. Supraglottic squamous cell carcinoma: a population-based study of 22,675 cases. Laryngoscope 2019;129(8):1822-7. google scholar
• 14. Nocini R, Molteni G, Mattiuzzi C, Lippi G. Updates on larynx cancer epidemiology. Chinese J Cancer Res 2020;32(1):18-25. google scholar
• 15. Verma A, Schwartz N, Cohen DJ, Boyan BD, Schwartz Z. Estrogen signaling and estrogen receptors as prognostic indicators in laryngeal cancer. Steroids 2019;152:108498. google scholar
• 16. Sak SD, Dursun G, Erekul S, Keser R, Beder E. The prognostic significance of histopathologic parameters in squamous cell carcinoma of the larynx. Turkish J Med Sci 1993;11(4):199-201. google scholar
• 17. Shuman AG, Larkin K, Thomas D, Palmer FL, Fins JJ, Baxi SS, et al. Patient reflections on decision making for laryngeal cancer treatment. Otolaryngol Head Neck Surg (United States) 2017;156(2):299-304. google scholar
• 18. Gourin CG, Dy SM, Herbert RJ, Blackford AL, Quon H, Forastiere AA, et al. Treatment, survival, and costs of laryngeal cancer care in the elderly. Laryngoscope 2014;124(8):1827-35. google scholar
• 19. Crosetti E, Caracciolo A, Arrigoni G, Fantini M, Sprio AE, Berta GN, et al. Management of T4a laryngeal cancer. Curr Otorhinolaryngol Rep 2017;5(1):69-82. google scholar
• 20. MR M. Transoral robotic supraglottic laryngectomy in laryngeal squamous cell carcinoma. Int J Otorhinolaryngol 2017;4(2):1-2. google scholar
• 21. Remacle M, Lawson G, Hantzakos A, Jamart J. Endoscopic partial supraglottic laryngectomies: techniques and results. Otolaryngol Head Neck Surg 2009;141(3):374-81. google scholar
• 22. Topaloğlu I, Bal M, Salturk Z. Supracricoid laryngectomy with cricohyoidopexy: oncological results. Eur Arch Oto-Rhino-Laryngology 2012;269(8):1959-65. google scholar
• 23. Mohamed Rifai, MD, Mohamed Salah Hassouna, MD, Ahmed El Farouk Abdel Fattah, MD, Hatem Badran M. Experience with supracricoid laryngectomy variants. Head Neck 2011;33(8):1177-83. google scholar
• 24. Hazarika B. Supracricoid partial laryngectomy: the second coming. An Int J Otorhinolaryngol Clin 2010;2(3):201-5. google scholar
• 25. Esposito EDAVE, Motta S, Cassiano B, Motta G. Occult lymph node metastases in supraglottic cancers of the larynx. Otolaryngol Neck Surg 2001;124(3):253-7. google scholar
• 26. Kürten CHL, Zioga E, Gauler T, Stuschke M, Guberina M, Ludwig JM, et al. Patterns of cervical lymph node metastasis in supraglottic laryngeal cancer and therapeutic implications of surgical staging of the neck. Eur Arch Oto-Rhino-Laryngology 2021;278(12):5021-7. google scholar
• 27. Zhang Y, Xu S, Liu W, Wang X, Wang K, Liu S, et al. Rational choice of neck dissection in clinically N0 patients with supraglottic cancer. Head Neck 2020;42(3):365-73. google scholar
• 28. Sessions DG, Lenox J, Spector GJ. Supraglottic laryngeal cancer: analysis of treatment results. Laryngoscope 2005;115(8):1402-10. google scholar
• 29. Scola B, Fernândez-Vega M, Martı'nez T, Fernândez-Vega S, Ramirez C. Management of cancer of the supraglottis. Otolaryngol Head Neck Surg 2001;124(2):195-8. google scholar
• 30. Markou KD, Vlachtsis KC, Nikolaou AC, Petridis DG, Kouloulas AI, Daniilidis IC. Incidence and predisposing factors of pharyngocutaneous fistula formation after total laryngectomy. Is there a relationship with tumor recurrence? Eur Arch Oto-Rhino-Laryngology 2004;261(2):61-7. google scholar
• 31. Wax MK, Touma BJ, Ramadan HH. Tracheostomal stenosis after laryngectomy: Incidence and predisposing factors. Otolaryngol -Head Neck Surg 1995;113(3):242-7. google scholar
• 32. Gallo O, Deganello A, Gitti G, Santoro R, Senesi M, Scala J, et al. Prognostic role of pneumonia in supracricoid and supraglottic laryngectomies. Oral Oncol 2009;45(1):30-8. google scholar
• 33. Shah-Becker S, Greenleaf EK, Boltz MM, Hollenbeak CS, Goyal N. Neck hematoma after major head and neck surgery: Risk factors, costs, and resource utilization. Head Neck 2018;40(6):1219-27. google scholar