SCIENTIFIC-PRACTICAL JOURNAL

| укр | рус |

 

 
Home Editorial ethics For authors Current issue Archive Contacts

No5-6(3) 2020

Back to the issue


DOI 10.37219/2528-8253-2020-6-12
Shportko B.V., Kovtunenko O.V., Tymchuk S.M.
Analysis of remote results of treatment of patients with laryngeal cancer
Shportko Bogdan Viktorovich
Municipal enterprise «Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov» Dnipropetrovsk Regional Council
Department of Otorhinolaryngology No. 2 (oncological)
Otolaryngologist
Email: bogdan.shportko@gmail.com
OrchidID: https://orcid.org/0000-0002-4242-2784

Kovtunenko Alexander Vasilievich
State Institution "Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine"
Professor of the Department of Otolaryngology
Doctor of Medical Sciences
Email: lor@dsma.dp.ua
Orchid ID: https://orcid.org/0000-0002-0562-7684

Tymchuk Sergey Nikolaevich
Municipal enterprise «Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov» Dnipropetrovsk Regional Council
Head of the Department of Otorhinolaryngology No. 2 (oncological)
Doctor of Medical Sciences
Email: sergej_lor@ukr.net
OrchidID: https://orcid.org/0000-0002-8706-2313

Abstract

Topicality: Today, laryngeal cancer occupies an important place in the structure of tumors of the head and neck. Malignant tumors of the larynx are most represented by squamous cell carcinoma, the main pathogenetic factors are smoking, alcohol and human papillomavirus.
The key factor is the presence of regional metastases, which significantly affects the survival of patients. Data on the five-year survival of patients with laryngeal cancer vary depending of the presence of metastases to regional lymph nodes from 60% lor patients with negative lymph node status to 18% lor stage N3b.
Aim of the study: To assess the survival of patients with laryngeal cancer, taking into account the presence of metastases and recurrences of the disease, to analyze the relationship between tumor recurrence and the presence of metastases at the beginning of observation.
Object and methods: 70 patients with laryngeal cancer of III-IV stages (T3-4N0-3M0) and II clinical group were understudy. Of these, 39 patients from the main group had regional metastases of laryngeal cancer, in 31 patients of the comparison group regional metastases were not detected. We investigated the frequency and timing of disease recurrence, metastasis, and death.
Results: During the observation period, metastases were detected in 6 patients (8.5%). During 1 year, metastases developed in 4 patients (percentage of patients without metastases – 93.1% (95% CI=86.8-99.9). Percentage of patients without metastases after 5 years – 85.7% (95% CI=74.2-99.1). The median time to metastasis in our study was 9.7 [7.2; 12.7] months.
During the follow-up period, 18 patients (26.4%) died of cancer-related causes. The majority of fatalities in our follow-up developed among patients with recurrence of the disease during the follow-up period. All patients who relapsed died during the follow-up period. One patient died within 1 year (survival – 98.4% (95% CI=95.2-100.0), five-year survival was 63.2% (95% CI=47.6-83.9), and the median time to death in our study was 21.4 [16.6; 26.2] months.
Conclusion: The critical period lor recurrence and metastasis was the first 12 months after treatment. Local recurrence during the first year of follow-up was associated with earlier mortality. The presence of metastases at the beginning of treatment reduced the risk of further metastasis by 7 times. The percentage of patients without metastases after 5 years was 85.7%. The five-year survival rate was 63.2%. The mean time to death in our study was 49.9
(2.7) months.

Keywords

cancer larynx, lymph node, metastasis, survival, recurrence.


Reference

  1. Audet N, Beasley NJ, MacMillan C, Jackson DG, Gullane PJ, Kamel-Reid S. Lymphatic vessel density, nodal metastases, and prognosis in patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2005 Dec;131:1065-70.https://doi.
    org/10.1001/archotol.131.12.1065 10.1001/archotol.131.12.1065.
  2. Barnes L, Eveson JW, Richard P, Sidransky D. World Health Organization Classification of Tumours: pathology and genetics of head and neck tumours. Lyon, France: IARC Press; 2005. 430 p.
  3. Bradford C, Kumar B, Bellile E, Lee J, Tailor J, D’Silva N, et al. Biomarkers in Advanced Larynx Cancer. Laryngoscope. 2014 Jan 24;124(1):179-87. doi: 10.1002/lary.24245.
  4. Cayonu M, Tuna EU, Acar A, Dinc ASK, Sahin MM, Boynuegri S, et al. Lymph node yield and lymph node density for elective level II-IV neck dissections in laryngeal squamous cell carcinoma patients. Eur Arch Otorhinolaryngol. 2019 Oct;276(10):2923-2927. doi:10.1007/s00405-019-05560-z
  5. Firke S. Janitor: simple tools lor examining and cleaning dirty data. 2020. Available from: https://CRAN.R-project.org/ package=janitor.
  6. Groome PA, O’Sullivan B, Irish JC, Rothwell DM, Schulze K, Warde PR, et al. Management and outcome differences in supraglottic cancer between Ontario, Canada, and the Surveillance, Epidemiology, and End Results areas of the United States. J Clin Oncol. 2003 Feb 1;21:496-505.
    doi: 10.1200/JCO.2003.10.106.
  7. Ho AS, Kim S, Tighiouart M, Gudino C, Mita A, Scher KS, et al. Association of quantitative metastatic lymph node burden with survival in hypopharyngeal and laryngeal cancer. JAMA Oncol. 2018 Jul 1;4(7):985-9. doi: 10.1001/jamaoncol.2017.3852.
  8. Imre A, Pinar E, Dincer E, Ozkul Y, Aslan H, Songu M, et al. Lymph node density in node-positive laryngeal carcinoma: analysis of prognostic value for survival. Otolaryngol Head Neck Surg. 2016 May 24;155(5):797-804. https://doi.org/10.1177/0194599816652371.
  9. Jiang Y, Goldberg ID, Shi YE. Complex roles of tissue inhibitors of metalloproteinases in cancer. Oncogene. 2002 Mar 18;21:2245-52.
    doi: 10.1038/sj.onc.1205291.
  10. Kariche N, Hortal M, Benyahia S, Alemany L, Moula N, Clavero O. Comparative assessment of HPV, alcohol and tobacco etiological fractions in Algerian patients with laryngeal squamous cell carcinoma. Infect Agent Cancer. 2018 Mar 15;13:8. doi: 10.1186/s13027-018-0181-x.
  11. Kassambara A, Kosinski M, Biecek P. Survminer: drawing survival curves using. 2020. Available from: https://CRAN.Rproject.org/package=survminer.
  12. Korampalli TS, Stafford ND. Expression of angiogenic growth factors in laryngeal carcinoma. Mol Clin Oncol. 2013 Nov;1(6):1013-1018.
    doi: 10.3892/mco.2013.179.
  13. Kovtunenko OV, Shportko BV, Tymchuk SM. Analysis of сytoceratine 19 expression level by immunocytochemical diagnostic method in laryngeal cancer patients with regional metastases. Wiad Lek 2020 Jul;73(7):1355-9. doi: 10.36740/WLek202007109.
  14. Ma J, Wang J, Fan W, Pu X, Zhang D, Fan C, et al. Upregulated TIMP-1 correlates with poor prognosis of laryngeal squamous cell carcinoma. International journal of clinical and experimental pathology. Int J Clin Exp Pathol. 2013 Dec 15;7(1):246-54. Available from: https://www.ncbi.
    nlm.nih.gov/pmc/articles/PMC3885479/.
  15. R Core Team. R: A Language and environment lor statistical computing. Vienna, Austria: R foundation lor statistical computing; 2020. Available
    from: https://www.R-project.org/.
  16. Robbins KT, Ferlito A, Shah JP, Hamoir M,Takes RP, Strojan P, et al. The evolving role of selective neck dissection lor head and neck squamous cell
    carcinoma. Eur Arch Otorhinolaryngol. 2013 Mar; 270(4):1195-202. doi:10.1007/s00405-012-2153-x.
  17. Sanabria A, Shah JP, Medina JE, Olsen KD, Robbins KT, Silver CE, et al. Incidence of occult lymph node metastasis in primary larynx squamous cell carcinoma, by subsite, T classification and neck level: a systematic review. Cancers (Basel). 2020 Apr 24;12(4):1059. doi:10.3390/cancers12041059.
  18. Steuer CE, El-Deiry M, Parks JR, Higgins KA, Saba NF. An update on larynx cancer. CA Cancer J Clin. 2017 Jan;67(1):31-50.
    doi:10.3322/caac.21386.
  19. Stokes WA, Jones BL, Bhatia S, Oweida AJ, Bowles DW, Raben D, et al. A comparison of overall survival for patients with T4 larynx cancer
    treated with surgical versus organ-preservation approaches: A National Cancer Data Base analysis. Cancer. 2017 Feb 15; 123(4):600-8.
    doi:10.1002/cncr.30382.
  20. Teymoortash A, Werner JA. Current advances in diagnosis and surgical treatment of lymph node metastasis in head and neck cancer. GMS Curr Top
    Otorhinolaryngol Head Neck Surg. 2012;11:Doc04. doi: 10.3205/cto000086.
 

© 2019, Public Organization «Ukrainian Scientific Medical Society of Otorhinolaryngologists»