Author/Editor		Sanabria, Alvaro; Chaves, Aline L. F.; Kowalski, Luiz P.; Wolf, Gregory T.; Saba, Nabil F.; Forastiere, Arlene A.; Beitler, Jonathan J.; Nibu, Ken-ichi; Bradford, Carol R.; Suárez, Carlos; Rodrigo, Juan Pablo; Strojan, Primož; Rinaldo, Alessandra; De Bree, Remco; Haigentz, Missak; Takes, Robert P.; Ferlito, Alfio
Title		Organ preservation with chemoradiation in advanced laryngeal cancer
Type		članek
Vol. and No.		Letnik 44, št. 1
Publication year		2017
Volume		str. 18-25
ISSN		1879-1476 - Auris, nasus, larynx
Language		eng
Abstract		The primary goal of treatment in advanced laryngeal cancer is to achieve optimal oncologic outcomes while preserving function and quality of life. Combination of chemotherapy and radiation has been popularized as an alternative to surgery for patients facing total laryngectomy. However, survival analyses from large, population-based databases have not duplicated results reported from randomized trials. METHODS: A comprehensive literature review was undertaken to try to better understand the reasons why results differ among randomized trials and population cohort studies. RESULTS: A variety of reasons are discussed, including differences in patient staging, selection bias, complexity bias, inconsistent terminology, patient compliance and treatment expertise. CONCLUSIONS: Personalized treatment considering all factors is critical for optimal outcomes. In general, evidence supports total laryngectomy for patients with T4 cancers. Definitive chemoradiotherapy strategies are acceptable alternatives for T3 cancers, provided that all resources for the administration of the treatment, follow-up and surgical salvage are available.
Keywords		obvarovanje organov kemoradioterapija rak grla laringektomija laringealne neoplazme organ preservation chemoradiotherapy laringeal cancer laringeal neoplasm laryngectomy