Laryngo-esophageal Dysfunction-free Survival in a Preservation Protocol for T3 Laryngeal Squamous-cell Carcinoma

Background: We reviewed the outcomes of patients with T3 laryngeal neoplasms with a fixed hemilarynx, a large gross tumor volume or a subglottic extension (SGE), treated with a laryngeal-preservation protocol with induction chemotherapy. Patients and Methods: The study end-points were laryngo-esophageal dysfunction-free survival (LEDFS), laryngectomy-free survival (LFS), overall survival (OS), and disease-free survival (DFS). Results: A total of 104 patients were included. The 2-year and 5-year OS rates were 70.4% and 54.5%, respectively. OS and DFS were independent of the treatment modality in the whole cohort (p=0.6546 and p=0.3006, respectively) and in patients with SGE (p=0.529 and p=0.255, respectively). The 2-year and 5-year LEDFS rates were 44.3% and 28.2%, respectively. LEDFS was not associated with initial hemilaryngeal fixation or SGE (p=0.5772 and p=0.0623, respectively). Conclusion: Chemoselection is feasible without compromised oncological or functional outcomes in patients with an initially fixed hemilarynx or subglottic extension.