Skip to main navigation menu Skip to main content Skip to site footer

Original article

Vol. 145 No. 4748 (2015)

Does airway intervention before primary nonsurgical therapy for T3/T4 laryngeal squamous cell carcinoma impact on oncological or functional outcomes?

  • René Schariatzadeh
  • Thomas Pezier
  • Gabriela Studer
  • Stephan Schmid
  • Gerhard Huber
Cite this as:
Swiss Med Wkly. 2015;145:w14213


QUESTIONS UNDER STUDY: Even today, some patients with laryngeal cancer present with airway obstruction necessitating an intervention in the form of either a tracheostomy or transoral laser debulking (TOL). Controversy exists as to whether such an intervention is a risk factor for poor oncological or functional outcome in patients who then undergo primary (chemo)radiotherapy.

METHODS: Retrospective chart review of all patients undergoing primary curative nonsurgical treatment for T3/T4 laryngeal squamous cell cancer at the University Hospital Zurich between 1981 and 2011.

RESULTS: A total of 29/114 patients had an airway intervention before initiation of (chemo)radiotherapy (21/29 tracheostomies, 8/29 TOL). Kaplan-Meier analysis showed no statistical difference in oncological outcomes between the groups with and without intervention (5 year overall survival: 52% vs 70%, disease specific survival: 73% vs 79%, recurrence free survival: 53% vs 63%). In functional terms, we report an overall functional larynx rate of 60%.

CONCLUSIONS: Airway intervention was not found to be a risk factor for poor oncological or functional outcome in this patient group.


  1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA: a cancer journal for clinicians. 2010;60(5):277–300.
  2. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. The Department of Veterans Affairs Laryngeal Cancer Study Group. N Engl J Med. 1991;324(24):1685–90.
  3. Forastiere AA, Goepfert H, Maor M, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med. 2003;349(22):2091–8.
  4. Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471–4.
  5. Studer G, Peponi E, Kloeck S, Dossenbach T, Huber G, Glanzmann C. Surviving hypopharynx-larynx carcinoma in the era of IMRT. Int J Radiat Oncol Biol Phys. 2010;77(5):1391–6.
  6. Olsen KD. Reexamining the treatment of advanced laryngeal cancer. Head & neck. 2010;32(1):1–7.
  7. Pezier TF, Nixon IJ, Joshi A, et al. Pre-operative tracheostomy does not impact on stomal recurrence and overall survival in patients undergoing primary laryngectomy. European archives of oto-rhino-laryngology: official journal of the European Federation of Oto-Rhino-Laryngological Societies. 2013;270(5):1729–35.
  8. Gilson SD, Stone EA. Surgically induced tumor seeding in eight dogs and two cats. J Am Vet Med Assoc. 1990;196(11):1811–5.
  9. Halfpenny W, McGurk M. Stomal recurrence following temporary tracheostomy. J Laryngol Otol. 2001;115(3):202–4.
  10. Glaninger J. Problem of implantation metastasis by intubation anesthesia in surgery of cancer of the larynx. Monatsschr Ohrenheilkd Laryngorhinol. 1959;93(3):170–8.
  11. Stell PM, van den Broek P. Stomal recurrence after laryngectomy: aetiology and management. J Laryngol Otol. 1971;85(2):131–40.
  12. Esteban F, Moreno JA, Delgado-Rodriguez M, Mochon A. Risk factors involved in stomal recurrence following laryngectomy. J Laryngol Otol. 1993;107(6):527–31.
  13. MacKenzie R, Franssen E, Balogh J, Birt D, Gilbert R. The prognostic significance of tracheostomy in carcinoma of the larynx treated with radiotherapy and surgery for salvage. Int J Radiat Oncol Biol Phys. 1998;41(1):43–51.
  14. Basheeth N, O’Leary G, Khan H, Sheahan P. Oncologic outcomes of total laryngectomy: impact of margins and preoperative tracheostomy. Head & neck. 2015;37(6):862–9.
  15. Zhao H, Ren J, Zhuo X, Ye H, Zou J, Liu S. Stomal recurrence after total laryngectomy: a clinicopathological multivariate analysis. Am J Clin Oncol. 2009;32(2):154–7.
  16. Petrovic Z, Djordjevic V. Stomal recurrence after primary total laryngectomy. Clin Otolaryngol Allied Sci. 2004;29(3):270–3.

Most read articles by the same author(s)