Our Summary

This research paper looks at the effectiveness of an additional surgery, called an elective neck dissection (END), for patients with a certain type of throat cancer who have already gone through radiation or chemotherapy. The study looked at patients treated at one specific center between 2002 and 2014, and measured how the extra surgery affected things like complication rates, survival rates, and the likelihood of the cancer coming back.

Out of 86 patients, 27 had the extra surgery. Only one of these patients had hidden cancer spread (4%), and in the group of 59 patients who didn’t have the extra surgery, three had the cancer come back in the region (5%). The study found that those who had the extra surgery had a significantly higher overall survival rate. The rate of complications wasn’t significantly different between the two groups.

Because of these findings, the researchers suggest considering the additional surgery at the time of the main throat surgery, especially because the chances of the cancer coming back after radiation or chemotherapy and the main surgery are quite high.

FAQs

  1. What is the purpose of an elective neck dissection (END) in throat cancer treatment?
  2. Did the study find any significant difference in complication rates between patients who had the extra surgery and those who didn’t?
  3. Based on the study, does the additional surgery improve the overall survival rate of throat cancer patients?

Doctor’s Tip

A doctor might tell a patient undergoing a laryngectomy to consider discussing the option of an elective neck dissection with their healthcare team. This additional surgery could potentially improve overall survival rates and reduce the likelihood of the cancer coming back in the region. It is important to weigh the potential benefits of the additional surgery against the risks and potential complications, and to have a thorough discussion with the healthcare team to make an informed decision.

Suitable For

Patients who are typically recommended laryngectomy are those with advanced laryngeal cancer that has not responded to other treatments such as radiation or chemotherapy. This may include patients with large tumors, tumors that have spread to nearby tissues or lymph nodes, or tumors that have recurred after initial treatment. Additionally, patients with certain types of throat cancer that have a high risk of recurrence may also be recommended for laryngectomy.

Timeline

Before laryngectomy:

  • Patient is diagnosed with throat cancer
  • Patient undergoes radiation or chemotherapy treatment
  • Patient may experience side effects such as difficulty swallowing, speaking, or breathing
  • Patient may have a tumor in the larynx that is not responding to treatment
  • Patient and medical team discuss the option of laryngectomy as a last resort

After laryngectomy:

  • Patient undergoes laryngectomy surgery to remove the larynx
  • Patient may need a tracheostomy tube to help with breathing
  • Patient may need speech therapy to learn how to communicate without a larynx
  • Patient may need to adjust to changes in eating and swallowing
  • Patient may need physical therapy to regain strength and mobility
  • Patient may need to follow up with regular check-ups and screenings to monitor for cancer recurrence

Overall, the patient’s quality of life may be impacted by the laryngectomy surgery, but with proper support and care, many patients are able to adapt and lead fulfilling lives after the procedure.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laryngectomy include:

  1. What are the potential risks and complications associated with laryngectomy surgery?
  2. How will my ability to speak, swallow, and breathe be affected after laryngectomy?
  3. What is the expected recovery time and rehabilitation process after laryngectomy surgery?
  4. Will I need additional treatments such as radiation or chemotherapy after laryngectomy?
  5. What long-term effects should I expect after laryngectomy?
  6. Are there any alternative treatment options to laryngectomy that I should consider?
  7. How often will I need follow-up appointments and monitoring after laryngectomy?
  8. How can I best prepare for laryngectomy surgery, both physically and emotionally?
  9. Are there support groups or resources available for patients who have undergone laryngectomy?
  10. Based on my specific case, would an elective neck dissection (END) be recommended as an additional surgery to reduce the risk of cancer recurrence?

Reference

Authors: Bernard SE, Wieringa MH, Meeuwis CA, Baatenburg de Jong RJ, Sewnaik A. Journal: Eur Arch Otorhinolaryngol. 2019 Apr;276(4):1127-1133. doi: 10.1007/s00405-018-5257-0. Epub 2019 Jan 4. PMID: 30610371