TY - JOUR
T1 - Selected laryngeal squamous cell carcinomas with laryngeal mobility impairment are suitable for curative larynx-preservation treatment
T2 - A multi-institutional study on 406 patients from the ARYFIX collaborative group
AU - Mularoni, Francesca
AU - Marchi, Filippo
AU - Gaudioso, Piergiorgio
AU - Taboni, Stefano
AU - Crosetti, Erika
AU - Carobbio, Andrea Luigi Camillo
AU - Bamfi, Giovanni
AU - Anile, Giuseppe
AU - Bandolin, Luigia
AU - Baldovin, Maria
AU - Bertotto, Ilaria
AU - Busato, Fabio
AU - Cagli, Sedat
AU - Caprioli, Simone
AU - Carta, Filippo
AU - Contro, Giacomo
AU - Del Bon, Francesca
AU - Dogan, Serap
AU - Fermi, Matteo
AU - Filauro, Marta
AU - Fior, Milena
AU - Gennarini, Francesca
AU - Gottardi, Chiara
AU - Gündog, Mete
AU - Ioppi, Alessandro
AU - Lancini, Davide
AU - Lionello, Marco
AU - Lo Manto, Alfredo
AU - Maiolo, Vincenzo
AU - Mariani, Cinzia
AU - Marioni, Gino
AU - Marrosu, Valeria
AU - Mazzola, Francesco
AU - Montalto, Nausica
AU - Missale, Francesco
AU - Pessina, Carlotta
AU - Paderno, Alberto
AU - Ramanzin, Marco
AU - Ravanelli, Marco
AU - Rigoni, Francesco
AU - Ruaro, Alessandra
AU - Saccardo, Tommaso
AU - Sampieri, Claudio
AU - Tatti, Melania
AU - Vallin, Alberto
AU - Varago, Chiara
AU - Yüce, Imdat
AU - Zanoletti, Elisabetta
AU - Bertolin, Andy
AU - Bossi, Paolo
AU - Et al.
AU - Ferrari, Marco
PY - 2025/8
Y1 - 2025/8
N2 - INTRODUCTION: Mobility impairment defines a specific subset of laryngeal squamous cell carcinoma (LSCC), with implications for prognosis and treatment. While total laryngectomy (TL) is often considered for mobility-impairing LSCC (MI-LSCC), the role of organ-preserving strategies such as open partial horizontal laryngectomy (OPHL) and non-surgical treatments (NST) remains debated. This study aims to evaluate the outcomes of different treatment strategies for patients with MI-LSCC. MATERIALS AND METHODS: A retrospective analysis was conducted on 406 MI-LSCC patients using data from the ARYFIX collaborative study. Patients with subglottic tumors or those receiving unimodal radiotherapy (RT) were excluded. Treatment modalities included TL, TL with adjuvant (chemo)radiotherapy ((C)RT), OPHL, OPHL with adjuvant (C)RT, and definitive NST. Survival outcomes, including overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and laryngo-esophageal dysfunction-free survival (LEDFS), were assessed. Population clustering and propensity score matching (PSM) were used to balance covariates across treatment groups. RESULTS: The 5-year rates of OS and DSS were 72.0% and 86.2%, respectively. PSM-adjusted analysis indicated that OPHL was associated with the best outcomes. TL with adjuvant (C)RT provided favorable oncologic control, while NST was associated with higher cancer-unrelated mortality and reduced locoregional control. However, NST yielded the best outcomes in patients with N2-3 MI-LSCC. OPHL followed by (C)RT was associated with inferior DSS and unfavorable LEDFS. CONCLUSION: In MI-LSCC, OPHL offers satisfactory oncologic and functional outcomes, provided that patient selection is performed carefully. NST, although associated with poorer locoregional control, optimizes outcomes in MI-LSCC with high nodal burden. Treatment for MI-LSCC should be individualized, considering tumor extension, patient fitness, and institutional expertise.
AB - INTRODUCTION: Mobility impairment defines a specific subset of laryngeal squamous cell carcinoma (LSCC), with implications for prognosis and treatment. While total laryngectomy (TL) is often considered for mobility-impairing LSCC (MI-LSCC), the role of organ-preserving strategies such as open partial horizontal laryngectomy (OPHL) and non-surgical treatments (NST) remains debated. This study aims to evaluate the outcomes of different treatment strategies for patients with MI-LSCC. MATERIALS AND METHODS: A retrospective analysis was conducted on 406 MI-LSCC patients using data from the ARYFIX collaborative study. Patients with subglottic tumors or those receiving unimodal radiotherapy (RT) were excluded. Treatment modalities included TL, TL with adjuvant (chemo)radiotherapy ((C)RT), OPHL, OPHL with adjuvant (C)RT, and definitive NST. Survival outcomes, including overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and laryngo-esophageal dysfunction-free survival (LEDFS), were assessed. Population clustering and propensity score matching (PSM) were used to balance covariates across treatment groups. RESULTS: The 5-year rates of OS and DSS were 72.0% and 86.2%, respectively. PSM-adjusted analysis indicated that OPHL was associated with the best outcomes. TL with adjuvant (C)RT provided favorable oncologic control, while NST was associated with higher cancer-unrelated mortality and reduced locoregional control. However, NST yielded the best outcomes in patients with N2-3 MI-LSCC. OPHL followed by (C)RT was associated with inferior DSS and unfavorable LEDFS. CONCLUSION: In MI-LSCC, OPHL offers satisfactory oncologic and functional outcomes, provided that patient selection is performed carefully. NST, although associated with poorer locoregional control, optimizes outcomes in MI-LSCC with high nodal burden. Treatment for MI-LSCC should be individualized, considering tumor extension, patient fitness, and institutional expertise.
KW - Laryngeal preservation treatment
KW - Laryngeal squamous cell carcinoma
KW - Non-surgical treatment
KW - Surgical strategies
KW - Vocal cord mobility impairment
U2 - 10.1016/j.oraloncology.2025.107466
DO - 10.1016/j.oraloncology.2025.107466
M3 - Article
SN - 1368-8375
VL - 167
JO - Oral Oncology
JF - Oral Oncology
M1 - 107466
ER -