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Options of medical treatment and laryngeal function preservation in elderly patients with medial wall pyriform sinus cancer

Authors Wang Q, Liu Y, Wu K, Zhao Y, Gao C, Tong B, Zhang M

Received 21 April 2018

Accepted for publication 23 August 2018

Published 1 November 2018 Volume 2018:11 Pages 7441—7446

DOI https://doi.org/10.2147/OTT.S171873

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 4

Editor who approved publication: Prof. Dr. Geoffrey Pietersz


Qin Wang,1,2 Yehai Liu,1 Kaile Wu,1 Yi Zhao,1 Chaobing Gao,1 Busheng Tong,1 Ming Zhang3,4

1Department of Otolaryngology, The First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China; 2Department of Otolaryngology, Hefei Second People’s Hospital, Hefei, People’s Republic of China; 3Department of Anatomy, Anhui Medical University, Hefei, People’s Republic of China; 4Department of Anatomy, University of Otago, Dunedin, New Zealand

Objective: To retrospectively investigate the clinical efficacy and larynx preservation of two different treatments: radiotherapy followed by surgery (R+S) and surgery followed by radiotherapy (S+R), in elderly patients with medial wall pyriform sinus cancer.
Materials and methods: Medical records from 48 patients over 70 years old with medial wall pyriform sinus cancer who underwent different treatments between 2001 and 2010 were analyzed. Twenty-one patients underwent radiotherapy first followed by surgery (R+S), and the other 27 patients underwent surgery first followed by radiotherapy (S+R). A Kaplan–Meier method was used to calculate the survival rate.
Results: Overall 3-year and 5-year survival rates were 60.4% and 35.4%, respectively. The 5-year survival rates in R+S group and S+R group were 38.1% and 33.3%, respectively, without a statistically significant difference between the two groups (P>0.05). Also, comparisons of the decannulation rates (64.3% for R+S group vs 50.0% for S+R group) and postoperative complication rates (42.9% for R+S group vs 37.0% for S+R group) between the two groups of patients did not show obvious differences. However, the laryngeal preservation rates in R+S group and S+R group were 66.7% and 37.0%, respectively, with significantly statistical difference between the two groups (P<0.05).
Conclusion: Based on the data analysis of 48 patients, the survival rates of elderly patients who underwent R+S or S+R were comparable, but R+S treatment could improve the laryngeal preservation rate of patients. Further study on large-scale sample pool should be performed to confirm this conclusion.

Keywords: medial wall pyriform sinus cancer, elderly patients, survival rate, larynx preservation

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