Clinical outcomes and XXXX after exclusive versus postoperative radiotherapy in @entity5 : new solutions for old problems? The case of @entity5 .

@entity1 @entity137 @entity5 @entity2133 @entity4 @entity33 @entity1282 @entity1168
PURPOSE: To compare @entity137 , survival and laryngeal preservation @entity1168 ( @entity1168 ), radiotherapy after supraglottic horizontal laryngectomy (SHLR) and radiotherapy after total laryngectomy (TLR) for advanced supraglottic @entity5 . MATERIALS AND METHODS: From 1984 to 2012, 532 @entity1 (pts) were treated in our Department: 273 were potentially fit for conservative surgery (Group I) and 259 were not amenable to partial surgery (Group II). RESULTS: A younger age (p = 0.005), a better performance status (p < 0.001), the absence of comorbidities (p < 0.001) and the absence of nodal involvement (p = 0.006) favorably impacted on overall survival. More high-grade @entity33 (p = 0.009), mild @entity1282 (p < 0.001) and mild @entity2133 (p < 0.001) were found in @entity1168 group; surgical @entity1 had more @entity4 of neck (p = 0.009) and @entity137 (p = 0.008). Group I No differences in local, nodal and distant recurrences and in number of rescue laryngectomies were observed. The disease characteristics (T, N and stage) but not the treatment modality impacted on disease-free survival (DFS). Group II There was an higher number of local (p = 0.013) and nodal (p = 0.022) recurrences after @entity1168 . DFS (p = 0.01) was longer after TLR. No differences in DFS between TLR @entity1 and @entity1168 @entity1 who underwent radio-chemotherapy were found. CONCLUSION: In Group I, @entity1168 results in a local-regional control and organ preservation comparable to surgical treatments, with only slight increase of late mild @entity2133 and @entity1282 . In Group II @entity1168 was less effective than TLR, with a significantly worse DFS. The use of concurrent radical radio-chemotherapy seems to provide comparable loco-regional control to TLR.
