Laryngeal preservation in ENT oncology. Retrospective series of 246 patients managed in the Caen University Hospital and François Baclesse Cancer Care Center between 1998 and 2008

ObjectivesA 10-year retrospective study investigated factors for survival and laryngeal preservation in advanced laryngeal, hypopharyngeal or epilaryngeal neoplasia.Material and methodTwo hundred and forty-six patients with advanced cancer of the larynx (17.48%), hypopharynx (48.78%) or epilarynx (33.74%) undergoing primary organ-sparing treatment were included from 1998 to 2008. Treatment comprised chemotherapy followed by radiation therapy for 92.68% of patients, isolated radiation therapy for 1.6% and concomitant or sequential radiation-chemotherapy for 5.7%. General health status, history and tumor status were recorded. Factors influencing survival were analyzed by Kaplan-Meier estimator, log-rank test and Cox models.ResultsMedian overall survival of the population was 2.3 years and median laryngeal preservation 0.99 years in male patients and 2 years in female patients. Survival correlated significantly with body mass index (BMI; P = 0.0004), WHO performance status (P = 0.0064), alcohol consumption (P = 0.0004) and cessation (P < 0.0001) and also T stage (P = 0.0038), initial laryngeal mobility (P = 0.0002) and post-chemotherapy assessment (P < 0.0001). Survival with functional larynx correlated with baseline BMI at first consultation (P = 0.016), baseline WHO grade (P = 0.0005), laryngeal mobility (P < 0.0001), T staging (P = 0.0009), and T and/or N chemotherapy response to a classical organ preservation protocol (P < 0.0001).ConclusionOver and above established criteria, the present study highlighted the importance of general health and nutritional status during treatment.