Our Summary

This research paper analyses the use of a procedure called Elective Neck Dissection (END) in treating a type of throat cancer that has come back. END is a surgical procedure that removes lymph nodes from the neck to prevent the spread of cancer. The researchers are trying to determine whether it’s beneficial to use this procedure when there are no obvious signs of cancer in the lymph nodes of the neck (clinically N0).

They searched for and analyzed past studies on this subject. They found that in cases where the cancer had returned, hidden cancer cells were found in the lymph nodes in 14% of cases. The chances of these hidden cells being present were higher in certain types of cancer (supraglottic and T3/T4 tumors) and lower in others.

They also found that the risk of complications after surgery was slightly higher in patients who underwent END compared to those who did not have the procedure. However, this result was not statistically significant, meaning it could have happened by chance.

The researchers concluded that the presence of hidden cancer cells in the lymph nodes is more likely in certain types of cancer, and this should be considered when deciding whether to perform END. The potential for post-surgery complications should also be taken into account.

FAQs

  1. What is the Elective Neck Dissection (END) procedure?
  2. What findings did the research paper present about the use of END in treating throat cancer?
  3. How does the presence of hidden cancer cells in the lymph nodes affect the decision to perform END?

Doctor’s Tip

A doctor might tell a patient who has undergone a laryngectomy that it’s important to follow a proper care routine for their stoma, which is the opening in their neck created during the surgery. This includes keeping the stoma clean, changing the stoma cover regularly, and protecting it from irritants. Additionally, the patient should be aware of how to properly care for their voice prosthesis, if one was inserted during the surgery, to ensure proper function and prevent infections. Regular follow-up appointments with their healthcare provider are also crucial to monitor for any complications or changes in their condition.

Suitable For

Patients who are typically recommended for laryngectomy are those with advanced throat cancer that has not responded to other forms of treatment, such as radiation or chemotherapy. Additionally, patients who have recurrent throat cancer or those with tumors that are large or have spread to nearby lymph nodes may also be candidates for laryngectomy. Ultimately, the decision to recommend laryngectomy depends on the individual patient’s specific situation and the recommendations of their medical team.

Timeline

Before laryngectomy:

  • Patient is diagnosed with throat cancer
  • Patient undergoes various tests and consultations to determine the stage and extent of the cancer
  • Treatment options are discussed, which may include surgery, radiation therapy, chemotherapy, or a combination of these
  • If surgery is chosen, the patient prepares for the procedure by meeting with the surgical team, undergoing preoperative tests, and making necessary arrangements for aftercare

After laryngectomy:

  • Patient undergoes the laryngectomy procedure, during which the voice box (larynx) is removed
  • Patient may need to stay in the hospital for a few days to recover from the surgery
  • Patient undergoes rehabilitation to learn how to speak without a voice box, which may involve speech therapy and the use of a prosthesis
  • Patient may need to make lifestyle adjustments, such as changes in diet and communication methods
  • Patient undergoes follow-up appointments and monitoring to check for any signs of recurrence or complications
  • Patient may need ongoing support and counseling to cope with the physical and emotional changes resulting from the surgery.

What to Ask Your Doctor

  1. What is a laryngectomy and why is it necessary in my case?
  2. What are the potential risks and complications associated with a laryngectomy surgery?
  3. What is the recovery process like after a laryngectomy?
  4. Will I be able to speak and swallow normally after the surgery?
  5. Are there any alternative treatment options to a laryngectomy that I should consider?
  6. How will a laryngectomy affect my quality of life in the long term?
  7. What support services are available for patients who have undergone a laryngectomy?
  8. How often will I need to follow up with my doctor after the surgery?
  9. Are there any lifestyle changes I should make to improve my outcome after a laryngectomy?
  10. What are the chances of the cancer returning after a laryngectomy, and what steps can I take to prevent this?

Reference

Authors: Lin C, Puram SV, Bulbul MG, Sethi RK, Rocco JW, Old MO, Kang SY. Journal: Oral Oncol. 2019 Sep;96:97-104. doi: 10.1016/j.oraloncology.2019.07.008. Epub 2019 Jul 17. PMID: 31422220