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Non-conventional laryngeal malignancies: a multicentre review of management and outcomes

  • Head and Neck
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Abstract

Purpose

Non-conventional laryngeal malignancies (NSCC) often have limited published data to guide management despite individual histopathological subtypes often exhibiting heterogeneous behaviour, characteristics, and treatment responses compared to laryngeal squamous cell carcinoma (SCC). This study aimed to compare oncological outcomes with SCC, specifically disease-free survival (DFS), disease-specific survival (DSS) and overall survival (OS). Secondary objectives were to compare treatment differences and perform a state of the art review.

Methods

This was a multicentre retrospective cohort study at four tertiary head and neck centres. Survival outcomes between NSCC and SCC patients were analysed with Kaplan–Meier curves and compared by log rank testing. Univariate Cox regression analysis was performed to predict survival by histopathological subgroup, T-stage, N-stage and M-stage.

Results

There were no significant differences in 3-year DFS (p = 0.499), DSS (p = 0.329), OS (p = 0.360) or Kaplan Meier survival curves (DSS/OS) between SCC and overall NSCC groups. However, univariate Cox regression analysis identified “rare” histopathologies (mostly small cell carcinoma) to be predictive of less favourable OS (p = 0.035) but this result was not observed for other NSCC histopathological subgroups. N-stage (p = 0.027) and M-stage (p = 0.048) also predicted OS for NSCC malignancies. Significant differences in treatment modalities were identified with treatment of NSCC typically involving surgical resection and SCC often managed non-surgically (e.g., primary radiotherapy).

Conclusions

Although overall NSCC is managed differently compared to SCC, there do not appear to be differences in survival outcomes between these groups. N-stage and M-stage appear to be more predictive of OS than histopathology than many NSCC subtypes.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland

    Rory J. O’Neill, Justin Hintze, Anthony Noone, Helen L. Barrett, Sherif Mamdouh, Neville Shine & James Paul O’Neill

  2. Royal College of Surgeons, Dublin, Ireland

    Rory J. O’Neill, Justin Hintze, Stephen Garry, Sherif Mamdouh & James Paul O’Neill

  3. Department of Otorhinolaryngology, Head and Neck Surgery, St James Hospital, Dublin, Ireland

    Adrinda Sharifah, Conrad Timon, John Kinsella & Paul Lennon

  4. Department of Otorhinolaryngology, Head and Neck Surgery, South Infirmary Victoria University Hospital, Cork, Ireland

    Patrick Sheahan

  5. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Galway, Galway, Ireland

    Stephen Garry & Orla Young

  6. Department of Histopathology, Beaumont Hospital, Dublin, Ireland

    Graham Woods

  7. Trinity College Dublin, Dublin, Ireland

    Conrad Timon

  8. University College Cork, Cork, Ireland

    Patrick Sheahan

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  1. Rory J. O’Neill
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O’Neill, R.J., Hintze, J., Sharifah, A. et al. Non-conventional laryngeal malignancies: a multicentre review of management and outcomes. Eur Arch Otorhinolaryngol 280, 3383–3392 (2023). https://doi.org/10.1007/s00405-023-07937-7

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  • DOI: https://doi.org/10.1007/s00405-023-07937-7

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