PMID- 28585496
OWN - NLM
STAT- MEDLINE
DCOM- 20170929
LR  - 20181113
IS  - 1097-6817 (Electronic)
IS  - 0194-5998 (Print)
IS  - 0194-5998 (Linking)
VI  - 157
IP  - 3
DP  - 2017 Sep
TI  - Preoperative Tracheostomy Is Associated with Poor Disease-Free Survival in 
      Recurrent Laryngeal Cancer.
PG  - 432-438
LID - 10.1177/0194599817709236 [doi]
AB  - Objectives It is unknown if preoperative tracheostomy for persistent/recurrent 
      laryngeal squamous cell carcinoma (LSCC) plays a role in unrecognized local 
      disease spread and disease recurrence after salvage laryngectomy. The goals of 
      this study were to determine the effect of preoperative tracheostomy on 
      disease-free survival (DFS) in patients with recurrent/persistent LSCC undergoing 
      salvage laryngectomy. Study Design Retrospective case series derived from 
      prospectively maintained database. Setting Tertiary care academic center. 
      Subjects Patients with recurrent/persistent LSCC after radiation/chemoradiation 
      (RT/CRT) who underwent salvage laryngectomy at the University of Michigan from 
      1997 to 2015. Methods Demographic, clinical, pathologic, and survival data were 
      collected. Kaplan-Meier survival estimates were performed. Results DFS was worse 
      for patients with tracheostomy prior to laryngectomy than patients without a 
      tracheostomy (5 year: 39% vs 67%; P < .001). Patients with tracheostomy prior to 
      RT/CRT compared to patients with tracheostomy after RT/CRT or patients without a 
      tracheostomy had worse DFS (5-year: 25%, 49%, and 67%, respectively; P < .001). 
      In bivariable analyses controlling for T classification, N classification, or 
      overall stage, preoperative tracheostomy was associated with worse DFS. In 
      multivariable analysis, presence of a preoperative tracheostomy had a worse DFS 
      (hazard ratio, 1.63; 95% confidence interval, 1.00-2.67; P = .048). Conclusion 
      Preoperative tracheostomy is associated with disease recurrence in patients with 
      persistent/recurrent LSCC undergoing salvage laryngectomy, particularly in 
      patients who had tracheostomy prior to completion of initial RT/CRT. Notably, 
      preoperative tracheostomy as a causal factor vs marker for disease recurrence is 
      difficult to ascertain. Nevertheless, clinicians should be aware of the increased 
      risk of locoregional recurrence in patients with preoperative tracheostomy when 
      counseling on surgical salvage and when considering the role of additional 
      therapy.
FAU - Birkeland, Andrew C
AU  - Birkeland AC
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Rosko, Andrew J
AU  - Rosko AJ
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Beesley, Lauren
AU  - Beesley L
AD  - 2 School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
FAU - Bellile, Emily
AU  - Bellile E
AD  - 2 School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
FAU - Chinn, Steven B
AU  - Chinn SB
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Shuman, Andrew G
AU  - Shuman AG
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Prince, Mark E
AU  - Prince ME
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Wolf, Gregory T
AU  - Wolf GT
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Bradford, Carol R
AU  - Bradford CR
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Brenner, J Chad
AU  - Brenner JC
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann 
      Arbor, Michigan, USA.
FAU - Spector, Matthew E
AU  - Spector ME
AD  - 1 Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann 
      Arbor, Michigan, USA.
LA  - eng
GR  - T32 CA083654/CA/NCI NIH HHS/United States
GR  - T32 DC005356/DC/NIDCD NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20170606
PL  - England
TA  - Otolaryngol Head Neck Surg
JT  - Otolaryngology--head and neck surgery : official journal of American Academy of 
      Otolaryngology-Head and Neck Surgery
JID - 8508176
SB  - IM
MH  - Carcinoma, Squamous Cell/*surgery
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Laryngeal Neoplasms/*surgery
MH  - *Laryngectomy
MH  - Male
MH  - Neoplasm Recurrence, Local/*surgery
MH  - Preoperative Care
MH  - Retrospective Studies
MH  - *Tracheostomy
PMC - PMC5593767
MID - NIHMS890573
OTO - NOTNLM
OT  - laryngeal squamous cell carcinoma
OT  - laryngectomy
OT  - salvage surgery
OT  - survival
OT  - tracheostomy
COIS- Conflict of interest: None
EDAT- 2017/06/07 06:00
MHDA- 2017/09/30 06:00
PMCR- 2018/09/01
CRDT- 2017/06/07 06:00
PHST- 2017/06/07 06:00 [pubmed]
PHST- 2017/09/30 06:00 [medline]
PHST- 2017/06/07 06:00 [entrez]
PHST- 2018/09/01 00:00 [pmc-release]
AID - 10.1177/0194599817709236 [doi]
PST - ppublish
SO  - Otolaryngol Head Neck Surg. 2017 Sep;157(3):432-438. doi: 
      10.1177/0194599817709236. Epub 2017 Jun 6.