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Published on: December 1, 2023
Vocal Cord Function Return After Larynx Preservation is Associated With Recurrence-Free Probability
Dauren Adilbay1, Ameya A Asarkar1,2, Rema Anisha Kandula1
1Department of Otolaryngology and Head Neck Surgery, Louisiana State University of Health Sciences, Shreveport, Louisiana, U.S.A.
Vocal cord mobility restoration after laryngeal cancer treatment is crucial. Patients with persistent vocal cord immobility face a higher risk of local recurrence, necessitating closer monitoring for early detection.
Area of Science:
- Otolaryngology
- Oncology
- Laryngeal Cancer Research
Background:
- Vocal cord fixation is a key staging factor in laryngeal cancer.
- Previous retrospective studies indicated vocal cord mobility restoration post-chemoradiotherapy as a favorable prognostic indicator.
Purpose of the Study:
- To prospectively evaluate the prognostic significance of vocal cord mobility restoration after definitive laryngeal cancer treatment.
- To determine if vocal cord mobility recovery impacts local recurrence and survival rates.
Main Methods:
- Prospective cohort study of 30 patients with laryngeal squamous cell carcinoma (T2/3, T4a) and vocal cord impairment/fixation.
- Chemoradiotherapy was the definitive treatment.
- Video laryngoscopy assessed vocal cord mobility before and 3 months after treatment.
- Primary endpoint: local recurrence-free probability; secondary endpoints: recurrence-free probability, disease-specific survival (DSS), and overall survival (OS).
Main Results:
- 60% of patients (18/30) achieved full vocal cord mobility recovery; 40% (12/30) had persistent impairment/fixation.
- Five-year local recurrence-free probability was significantly worse in the impaired group (46%) compared to the restored mobility group (85%) (p=0.012).
- Vocal cord mobility restoration was a significant predictor of local recurrence-free probability (HR 6.15).
Conclusions:
- Absence of vocal cord mobility restoration is linked to poorer local recurrence-free probability following laryngeal preservation treatment.
- Patients with persistent vocal cord immobility require vigilant follow-up for early detection of recurrence.
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