Supraglottic carcinoma

Impact of radiation therapy on outcome of patients with positive margins and extracapsular nodal disease

V. Rao Devineni, Joseph R. Simpson, Donald Sessions, J. Gershon Spector, Richard E Hayden, John Fredrickson, Barbara Fineberg

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Seventy-nine patients with supraglottic carcinoma treated between 1966 and 1985 are reviewed. All patients were treated with surgery and postoperative radiation therapy. Thirty-five percent of the patients had positive margins at the site of resection of the primary tumor. Of the 25 patients who had positive nodal disease, 13 patients (52%) had either extracapsular extension or soft-tissue or adjacent organ invasion, referred to in composite as “grave signs.” The median follow-up of the patients was 4.9 years and all patients were followed for a minimum of 3 years. The disease-free survival for all patients was 76% at 2 years and 71% at 3 years. The locoregional control rate for all patients was 70%.This study demonstrates that there is no difference in local recurrence or disease-free survival, or time to recurrence relative to the status of the surgical margins, which may be a benefit of the postoperative radiation therapy. This study also demonstrates that there is an increase in the number of patients with grave signs with increasing nodal stage. The rate of neck recurrence in patients with grave signs was substantially higher (54%) than in patients without grave signs (8%), even though these patients also had positive lymph nodes. Interestingly, there was also a higher rate of local recurrence among patients who had grave signs. Patients receiving doses higher than 6000 cGy to the primary site had fewer local failures, although within each group of patients with positive or negative surgical margins the differences in survival were minimal.

Original languageEnglish (US)
Pages (from-to)767-770
Number of pages4
JournalLaryngoscope
Volume101
Issue number7
StatePublished - 1991
Externally publishedYes

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Radiotherapy
Carcinoma
Recurrence
Disease-Free Survival
Neck
Lymph Nodes

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Devineni, V. R., Simpson, J. R., Sessions, D., Spector, J. G., Hayden, R. E., Fredrickson, J., & Fineberg, B. (1991). Supraglottic carcinoma: Impact of radiation therapy on outcome of patients with positive margins and extracapsular nodal disease. Laryngoscope, 101(7), 767-770.

Supraglottic carcinoma : Impact of radiation therapy on outcome of patients with positive margins and extracapsular nodal disease. / Devineni, V. Rao; Simpson, Joseph R.; Sessions, Donald; Spector, J. Gershon; Hayden, Richard E; Fredrickson, John; Fineberg, Barbara.

In: Laryngoscope, Vol. 101, No. 7, 1991, p. 767-770.

Research output: Contribution to journalArticle

Devineni, VR, Simpson, JR, Sessions, D, Spector, JG, Hayden, RE, Fredrickson, J & Fineberg, B 1991, 'Supraglottic carcinoma: Impact of radiation therapy on outcome of patients with positive margins and extracapsular nodal disease', Laryngoscope, vol. 101, no. 7, pp. 767-770.
Devineni, V. Rao ; Simpson, Joseph R. ; Sessions, Donald ; Spector, J. Gershon ; Hayden, Richard E ; Fredrickson, John ; Fineberg, Barbara. / Supraglottic carcinoma : Impact of radiation therapy on outcome of patients with positive margins and extracapsular nodal disease. In: Laryngoscope. 1991 ; Vol. 101, No. 7. pp. 767-770.
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