Laryngeal cancer occurred in Europe in 2020 with an incidence of 5.2 per 100,000 inhabitants, with nearly 25,000 new cases. Approximately 40% of these lesions are locally advanced laryngeal cancers (T3 and T4), representing a group of lesions historically treated with total laryngectomy, with or without postoperative radiotherapy. However, over the past 40 years, this type of surgery has declined dramatically in favor of the new organ-sparing strategies. Therefore, multiple surgical and non-surgical approaches have been developed (such as transoral surgeries, open partial laryngectomies, chemoradiotherapy protocols), with comparable survival outcomes but with significantly different functional outcomes in terms of quality of life, residual voice and ability to swallow.
In fact, even though the surgical radicality is still crucial, the preservation of quality of life and laryngeal functions has become an increasingly important goal to be shared with a multidisciplinary team, which must also consider pulmonary, cardiological, neurological comorbidities and the overall performance status, which could contraindicate some types of surgery due to the postoperative risk of aspiration and pneumonia.
It is essential to underline how heterogeneous locally advanced laryngeal cancers are, especially in stage T3 (for example anterior versus posterior, minimal versus massive invasion of the paraglottic space, pre-epiglottic space invasion, erosion of inner cortex of the thyroid cartilage), and this heterogeneity leads to a broad spectrum of possible treatments, such as radiotherapy and adjuvant chemotherapy, total laryngectomy, in some cases open partial laryngectomy or in selected patients also transoral surgery. Unfortunately, there is little evidence comparing the results of organ preservation surgery to chemoradiotherapy, just as we have very limited data on conservative surgery for selected T4 patients, for whom the standard treatment remains total laryngectomy.
The purpose of this research topic is therefore to focus on organ-preserving surgical strategies, in particular on their indications, functional and oncological outcomes, on their comparison with total laryngectomy and other non-surgical curative strategies.
All types of papers are welcome, including, but not limited to:
- Clinical trials
- Clinical studies
- Case reports
- Review articles
- Translational research
Keywords: Conservation Laryngeal Surgery, Laryngeal Cancer, Surgery, Laryngectomy, Surgical and Non-Surgical Strategies
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