Survival outcomes and predictors for patients who failed chemoradiotherapy/radiotherapy and underwent salvage total laryngectomy

Ming Hsien Tsai, Hui Ching Chuang, Yu Tsai Lin, Tai Lin Huang, Fu Min Fang, Hui Lu, Chih Yen Chien*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

3 Scopus citations

Abstract

Background: To assess the presence of adverse pathological features at the time of salvage total laryngectomy (TL) associated with oncologic outcome. Methods: Ninety patients with persistent/locally recurrent disease and who subsequently underwent salvage TL after definitive treatment by radiation alone (RTO) or concurrent chemo-radiation (CCRT) from 2009 to 2018 were retrospectively enrolled. Kaplan–Meier methods were used to estimate overall survival (OS), diseasespecific survival (DSS), and disease-free survival (DFS). Results: Lymphovascular invasion (LVI), perineural invasion, positive margin, and stage IV disease were associated with worse survival in the univariate analysis. In the multivariate analysis, the presence of LVI and positive margin were both independent negative predictors in OS (LVI: Adjusted hazard ratio (aHR) = 2.537, 95% CI: 1.163–5.532, p = 0.019; positive margin: AHR = 5.68, 95% CI: 1.996–16.166, p = 0.001), DSS (LVI: AHR = 2.975, 95% CI: 1.228–7.206, p = 0.016); positive margin: AHR = 11.338, 95% CI: 2.438–52.733, p = 0.002), and DFS (LVI: AHR 2.705, 95% CI: 1.257–5.821, p = 0.011; positive margin (aHR = 6.632, 95% CI: 2.047–21.487, p = 0.002). Conclusions: The presence of LVI and positive margin were both associated with poor OS, DSS, and DFS among patients who underwent salvage TL after failure of RTO/CCRT. The role of adjuvant therapy for high-risk patients after salvage TL to improve the chance of survival requires more investigation in the future.

Original languageEnglish
Article number371
Pages (from-to)1-9
Number of pages9
JournalInternational Journal of Environmental Research and Public Health
Volume18
Issue number2
DOIs
StatePublished - 02 01 2021

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

  • Hypopharyngeal cancer
  • Laryngeal cancer
  • Lymphovascular invasion
  • Prognosis
  • Surgical margin

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