Our Summary

This research paper looks at the outcomes of patients who had to undergo surgery after radiation therapy for early-stage cancer of the voice box, specifically the glottis (the part of the larynx containing the vocal cords). The study found that the cancer returned in about 40% of cases after radiation therapy. For these patients, the primary remaining treatment option was a type of surgery called salvage total laryngectomy, which involves removing the entire larynx.

The researchers reviewed the cases of 43 patients who had this surgery. They found that the average time for the cancer to return after radiation therapy was about 23 months. Among the patients studied, about 77% had the salvage total laryngectomy surgery.

The study identified several factors that were associated with better survival rates. These included the mobility of the vocal cords both at the beginning of treatment and at the time the cancer returned, as well as any changes in mobility. The researchers concluded that the mobility of the vocal cords is an important factor in deciding on the best treatment for early-stage glottis cancer, and should be closely monitored during the patient’s follow-up care.

FAQs

  1. What is the rate of disease relapse after radiotherapy for early-stage glottic laryngeal neoplasms?
  2. What is salvage total laryngectomy and when is it used?
  3. How does vocal cord mobility affect the treatment decision making for early-stage glottis carcinoma?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vocal cord surgery is to prioritize vocal cord mobility as an important factor in treatment decision making and during follow-up. Maintaining good vocal cord function before and after surgery can greatly impact outcomes and overall survival rates. It is important to discuss any changes in vocal cord mobility with your healthcare provider and follow their recommendations for postoperative care and rehabilitation to optimize your chances of a successful recovery.

Suitable For

Patients who are typically recommended vocal cord surgery include those with early-stage glottic laryngeal neoplasms who have experienced disease relapse after radiotherapy. Salvage total laryngectomy may be recommended as a treatment option for these patients. Prognostic factors such as initial vocal cord mobility, vocal cord mobility at the time of recurrence, and changes in mobility are important considerations in the decision-making process for vocal cord surgery in these patients.

Timeline

Before vocal cord surgery:

  • Patient is diagnosed with early-stage carcinoma of the glottic larynx
  • Patient undergoes radiotherapy as primary treatment
  • Disease relapses occur in up to 40% of cases after radiotherapy
  • Salvage total laryngectomy (STL) is recommended as the remaining treatment option
  • Patient undergoes evaluation for salvage surgery, including assessment of vocal cord mobility and histopathologic data

After vocal cord surgery:

  • Recurrences occur on average 22.7 months after the end of radiotherapy
  • Surgery is performed, with salvage total laryngectomy being the most common procedure
  • Prognostic factors such as initial vocal cord mobility, vocal cord mobility at the diagnosis of recurrence, and changes in mobility are assessed
  • Overall and disease-free survival rates are calculated and compared among subgroups
  • Vocal cord mobility is identified as an important clinical criterion in treatment decision making and during follow-up for early-stage glottic larynx carcinoma patients

What to Ask Your Doctor

  1. What are the potential risks and complications associated with vocal cord surgery?
  2. What is the success rate of vocal cord surgery in treating early-stage carcinoma of the glottic larynx after radiotherapy?
  3. What is the recovery process like after vocal cord surgery?
  4. How soon after vocal cord surgery can I expect to see improvements in my voice and swallowing?
  5. Will I need speech therapy or rehabilitation after vocal cord surgery?
  6. Are there any long-term effects or limitations to consider after vocal cord surgery?
  7. How often will I need follow-up appointments after vocal cord surgery?
  8. What are the chances of recurrence of the disease after vocal cord surgery?
  9. Are there any alternative treatments or options to consider before deciding on vocal cord surgery?
  10. What is the expected outcome or prognosis for my specific case after vocal cord surgery?

Reference

Authors: Gorphe P, Blanchard P, Temam S, Janot F. Journal: Eur Arch Otorhinolaryngol. 2015 Oct;272(10):3013-8. doi: 10.1007/s00405-014-3286-x. Epub 2014 Sep 14. PMID: 25218197