OncoTargets and Therapy (Nov 2018)

Options of medical treatment and laryngeal function preservation in elderly patients with medial wall pyriform sinus cancer

  • Wang Q,
  • Liu Y,
  • Wu K,
  • Zhao Y,
  • Gao C,
  • Tong B,
  • Zhang M

Journal volume & issue
Vol. Volume 11
pp. 7441 – 7446

Abstract

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Qin Wang,1,2 Yehai Liu,1 Kaile Wu,1 Yi Zhao,1 Chaobing Gao,1 Busheng Tong,1 Ming Zhang3,4 1Department of Otolaryngology, The First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China; 2Department of Otolaryngology, Hefei Second People’s Hospital, Hefei, People’s Republic of China; 3Department of Anatomy, Anhui Medical University, Hefei, People’s Republic of China; 4Department of Anatomy, University of Otago, Dunedin, New ZealandObjective: To retrospectively investigate the clinical efficacy and larynx preservation of two different treatments: radiotherapy followed by surgery (R+S) and surgery followed by radiotherapy (S+R), in elderly patients with medial wall pyriform sinus cancer.Materials and methods: Medical records from 48 patients over 70 years old with medial wall pyriform sinus cancer who underwent different treatments between 2001 and 2010 were analyzed. Twenty-one patients underwent radiotherapy first followed by surgery (R+S), and the other 27 patients underwent surgery first followed by radiotherapy (S+R). A Kaplan–Meier method was used to calculate the survival rate.Results: Overall 3-year and 5-year survival rates were 60.4% and 35.4%, respectively. The 5-year survival rates in R+S group and S+R group were 38.1% and 33.3%, respectively, without a statistically significant difference between the two groups (P>0.05). Also, comparisons of the decannulation rates (64.3% for R+S group vs 50.0% for S+R group) and postoperative complication rates (42.9% for R+S group vs 37.0% for S+R group) between the two groups of patients did not show obvious differences. However, the laryngeal preservation rates in R+S group and S+R group were 66.7% and 37.0%, respectively, with significantly statistical difference between the two groups (P<0.05).Conclusion: Based on the data analysis of 48 patients, the survival rates of elderly patients who underwent R+S or S+R were comparable, but R+S treatment could improve the laryngeal preservation rate of patients. Further study on large-scale sample pool should be performed to confirm this conclusion.Keywords: medial wall pyriform sinus cancer, elderly patients, survival rate, larynx preservation

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