Vol.99 No.4 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 4 April 2006
Clinical Review of Laryngeal Cancer:
a Series of 626 Cases over the Past 33 Years
Meijin Nakayama, Makito Okamoto, Masahiko Takeda,
Syunsuke Miyamoto and Yutomo Seino
(Kitasato University School of Medicine)
Treatment modalities of laryngeal cancer have enormously evolved since 1971, the year our university hospital opened. In the 1970's, there were only two treatment options: radiation therapy and surgery. Chemotherapy and laser surgery were employed in the 1980's and organ preservation surgery, supracricoid laryngectomy with cricohyoidoepiglottopexy and cricohyoidopexy (SCL-CHEP and CHP), were introduced in 1997 at Kitasato University Hospital. This paper reviewed the clinical data of 626 patients over the past 33 years. Special interest was focused on the survival rates and ratio of laryngeal preservation over different treatment eras (early stage 1971-1982, mid stage 1983-1993, recent stage 1994-2004).
Five-year crude and cause-specific survival rates for all laryngeal cancer patients were 76％ and 85％ respectively.
Five-year cause-specific survival rates for 456 patients with glottic cancers were 91％ (early stage), 91％ (mid stage), and 89％ (recent stage). Survival rate was already at the upper level and there was no marked difference among the different eras. Introduction of chemotherapy did not significantly contribute to improvement of the survival rate.
The ratios of laryngeal preservation were 68％, 81％, 83％ for early, mid, and recent stages, respectively. Chemoradiotherapy, introduced after the mid stage, has played a major role in laryngeal preservation.
Organ preservation surgery, SCL-CHEP and SCL-CHP, played a major role in the recent stage for treating cases of radiation failure or selected cases of advanced diseases.
UICC staging for laryngeal cancer was revised in 2002. Special attention must be paid to classifying the T3 stage based on the clinical features and CT images in order to choose the proper treatment modalities.
Key words : laryngeal cancer, supracricoid laryngectomy with cricohyoidoepiglottopexy, laryngeal preservation