Janot F, Rhein B, Koka V N, Wibault P, Domenge C, Bessede J P, Marandas P, Schwaab G, Luboinski B
Département d'ORL et Chirurgie Cervico-Faciale, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94805, Villejuif.
Ann Otolaryngol Chir Cervicofac. 2002 Feb;119(1):12-20.
This is a retrospective study of laryngeal preservation in endolaryngeal cancer with induction chemotherapy and radiotherapy for good responders. Between 1985 and 1995, 104 patients were treated in Institut Gustave Roussy (87 patients) and in Limoges (17 patients). The overall survival for the whole population was 76% and 69% at 3 and 5 years respectively, with a 36% rate of laryngeal preservation. In this retrospective series of patients, the single prognostic factor affecting survival was arytenoid mobility before treatment (66% and 55% at 3 years vs 85% and 82% at 5 years; p<0.004). Loco-regional failures were higher (33% vs 15%, p<0.03), and laryngeal preservation was lower (18% vs 51%) among patients with a fixed arytenoid (49 pts), compared with patients with a non fixed arytenoid (55 pts) ). The percentages of patients with a fixed arytenoid could explain the conflicting results of the two randomized studies of laryngeal preservation in laryngeal cancer.