Department of ORL-HNS, Nottingham University Hospitals, Queens Medical Centre Campus, Derby Road, Nottingham, UK.
Department of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili of Brescia, Department of Medical and Surgical Specialties, University of Brescia, Brescia, Italy.
Curr Opin Otolaryngol Head Neck Surg. 2021 Apr 1;29(2):65-78. doi: 10.1097/MOO.0000000000000684.
Laryngeal cancer continues to require improvement in earlier stage diagnosis and better imaging delineation of disease, and hence 'more evidence-based' selection of treatment, as recent evidence suggests that related mortality, in the last decades, has not significantly decreased worldwide. Even though the reasons are not fully understood, there persists an urgency for a review and development of future strategies to embrace such clinical and diagnostic challenges from a political, societal, as well as scientific and clinical points of view.
This review of the published literature suggests that survival improvement in laryngeal cancer may be achieved by fuelling and combining at least some or all of six targeted agendas: documentation of disease global incidence and national burden monitoring; development and implementation of high-quality cancer registries; education on risk factors and hazardous habits associated with laryngeal cancer for the general population; active modification of proven at-risk population lifestyles; centralization of treatment; and use of machine learning of gathered 'big data' and their integration into approaches for the optimization of prevention and treatments strategies.
Laryngeal cancer should be tackled on several fronts, commencing with disease monitoring and prevention, up to treatment optimisation. Available modern resources offer the possibility to generate significant advances in laryngeal cancer management. However, each nation needs to develop a comprehensive approach, which is an essential prerequisite to obtain meaningful improvement on results.
尽管原因尚不完全清楚，但鉴于最近的证据表明，在过去几十年中，全球范围内与喉癌相关的死亡率并没有显著下降，因此仍有必要改进早期诊断和更好地对疾病进行影像学描绘，从而“基于更多证据”选择治疗方案。
通过推动并结合至少部分或全部以下六个有针对性的议程，可能会提高喉癌的生存率：记录疾病的全球发病率和国家负担监测；制定和实施高质量的癌症登记册；针对普通人群开展与喉癌相关的危险因素和危险习惯的教育；积极改变已确定的高危人群的生活方式；集中治疗；以及利用收集到的“大数据”进行机器学习，并将其纳入预防和治疗策略的优化方法中。
应从疾病监测和预防开始，多管齐下地治疗喉癌，直至优化治疗效果。现有的现代资源提供了在喉癌管理方面取得重大进展的可能性。然而，每个国家都需要制定全面的方法，这是取得有意义的结果改进的必要前提。
